A DHS researcher has received a prestigious fellowship grant from the federal government.
Postdoctoral researcher Andi Camden received the fellowship from the Canadian Institutes of Health Research to study the perinatal health impacts of medication use by people with disabilities during pregnancy.
Dr. Camden’s newest project will examine medication use, including opioid prescribing, in pregnancy among people with disabilities, the first study of its kind in Canada.
The project’s aim is to describe the prevalence and patterns of medication use in pregnancy among people with disabilities by disability group and medication type, and determine the impact of disability and medication use on perinatal health.
Dr. Camden says: “There have been some changes to the clinical practice guidelines for opioid prescribing over the years and we’re seeing some prescribing rates coming down, but there's definitely concern among people with disabilities that opioids are being overprescribed.”
“Studies from the US have shown that people with disabilities are more likely to have longer durations and higher doses of opioids prescribed to them,” she adds. “They add to the risk of having adverse perinatal health outcomes, for instance higher rates of preterm birth, fetal growth restriction, and congenital anomalies. It varies with the type of opioid and other social and environmental factors as well.”
Dr. Camden will use healthcare records to estimate prevalence of medication use including opioids before and during pregnancy in people with and without disabilities, and examine the patterns to determine whether prenatal medication use partly explains the elevated risk of adverse birth outcomes among people with disabilities compared to those without disabilities.
“We're putting together an advisory group of people who have lived experience of disability and of medication use in pregnancy,” adds Dr. Camden. “They'll be involved throughout the whole process - guiding the research, helping us interpret the findings and then helping us to develop tools to take back to community.”
Dr. Camden intends the research to assist healthcare practitioners in understanding the complex issues around medication use in pregnancy, including opioid use, with the aim of reducing medication-related harm and related perinatal health complications.
“Opioid use in pregnancy is a very complex public health issue,” she explains. “A lot of people who use opioids have compounded risk factors. They are more likely to experience a range of health disparities, they're more likely to live in poverty, have a mental illness, polysubstance use, and chronic pain conditions.
“It's a very structurally marginalized population that's in need of comprehensive, integrated care that is flexible, non-judgmental, and addresses a range of issues. We need to address social supports, mental health, histories of trauma, and healthcare needs, in addition to addiction. We know that this is an important public health problem, but there's not a lot of specific guidance to help healthcare practitioners support people through pregnancy and the postpartum period.”