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  • Quality Improvement Article
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Using buprenorphine to treat neonatal abstinence syndrome: a quality improvement study

Journal of Perinatology volume 41, pages 1480–1486 (2021)Cite this article

Subjects

Abstract

Objective

To assess if treating neonatal abstinence syndrome (NAS) with sublingual buprenorphine (SLB) would decrease the mean duration of therapy (DOT) and length of birth hospital stay (LOS).

Study design

Conducted at a tertiary hospital with >6000 annual deliveries and a 2% incidence of NAS, a quality improvement study using plan-do-study-act (PDSA) cycles were utilized. Outcomes were measured using statistical process control (SPC) charts.

Results

All NAS patients were treated with SLB, no adverse reactions were reported and the need for an adjunctive agent was static. SPC charts demonstrated decreased variability and special cause variation indicating a reduction in both DOT (from 14.5 to 8.5 days) and LOS (from 18.5 to 13 days).

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Fig. 1
Fig. 2: Run chart for the percentage of infants started on buprenorphine.
Fig. 3: SPC chart for duration of therapy.
Fig. 4: SPC chart for length of hospital stay.
Fig. 5: Intrauterine exposures 2016–2018.

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Acknowledgements

Dr. Jennifer Check for her assistance with statistical analysis.

Author information

Authors and Affiliations

  1. Wake Forest University Baptist Medical Center, Brenner Children’s Hospital, Winston-Salem, NC, USA

    Sagar Bhandary, Tinisha Lambeth & Mary Pylipow

  2. Novant Health Forsyth Medical Center, Winston-Salem, NC, USA

    Tinisha Lambeth & Amy Holmes

Authors
  1. Sagar Bhandary
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  2. Tinisha Lambeth
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  3. Amy Holmes
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  4. Mary Pylipow
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Contributions

SB helped conceptualize and design the study, played a key role in implementation, data collection, analyses and drafted the initial manuscript, and reviewed and revised the manuscript. TL played a key role in the QI design and analysis of the data, assisted in the implementation, and reviewed and revised the manuscript. AH helped make the product available through pharmacy, assisted in monitoring compliance in the use of SLB on the floor, and reviewed and revised the manuscript. MP conceptualized and helped design the study, assisted in the implementation, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Sagar Bhandary.

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The authors declare no competing interests.

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Bhandary, S., Lambeth, T., Holmes, A. et al. Using buprenorphine to treat neonatal abstinence syndrome: a quality improvement study. J Perinatol 41, 1480–1486 (2021). https://doi.org/10.1038/s41372-021-01035-4

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