{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:49:02Z","timestamp":1792176542434,"version":"4.4.0"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>To evaluate the generalizability of stringent protocol-driven weaning in improving total duration of opioid treatment and length of inpatient hospital stay after treatment of neonatal abstinence syndrome (NAS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort analysis of 981 infants who completed pharmacologic treatment of NAS with methadone or morphine from January 2012 through August 2014. Before July 2013, 3 of 6 neonatology provider groups (representing Ohio\u2019s 6 children\u2019s hospitals) directed NAS nursery care by using group-specific treatment protocols containing explicit weaning guidelines. In July 2013, a standardized weaning protocol was adopted by all 6 groups. Statistical analysis was performed to identify effects of adoption of the multicenter weaning protocol on total duration of opioid treatment and length of hospital stay at the protocol-adopting sites and at the sites with preexisting protocol-driven weaning.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>After adoption of the multicenter protocol, infants treated by the 3 groups previously without stringent weaning guidelines experienced shorter duration of opioid treatment (23.0 vs 34.0 days, P &amp;lt; .001) and length of inpatient hospital stay (23.7 vs 31.6 days, P &amp;lt; .001). Protocol-adopting sites also experienced a lower rate of adjunctive drug therapy (5% vs 21%, P = .004). Outcomes were sustained by the 3 groups who initially had specific weaning guidelines after multicenter adoption (duration of treatment = 17.0 days and length of hospital stay = 23.3 days).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Adoption of a stringent weaning protocol resulted in improved NAS outcomes, demonstrating generalizability of the protocol-driven weaning approach. Opportunity remains for additional protocol refinement.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2015-1141","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T00:48:33Z","timestamp":1442278113000},"page":"e803-e810","source":"Crossref","is-referenced-by-count":69,"title":["Implementation of a Neonatal Abstinence Syndrome Weaning Protocol: A Multicenter Cohort Study"],"prefix":"10.1542","volume":"136","author":[{"given":"Eric S.","family":"Hall","sequence":"first","affiliation":[{"name":"Perinatal Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Wexelblatt","sequence":"additional","affiliation":[{"name":"Perinatal Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"Crowley","sequence":"additional","affiliation":[{"name":"Pediatrics, University Hospitals Rainbow Babies and Children\u2019s Hospital and Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Grow","sequence":"additional","affiliation":[{"name":"Pediatrix Medical Group of Ohio, Akron Children\u2019s Hospital, Akron, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa R.","family":"Jasin","sequence":"additional","affiliation":[{"name":"Department of Nursing, Dayton Children\u2019s Hospital, Dayton, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Klebanoff","sequence":"additional","affiliation":[{"name":"The Research Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"McClead","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Nationwide Children\u2019s Hospital, Columbus, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jareen","family":"Meinzen-Derr","sequence":"additional","affiliation":[{"name":"Perinatal Institute, and"},{"name":"Biostatistics and Epidemiology, Cincinnati Children\u2019s Hospital, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedagiri K.","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Neonatology, ProMedica Toledo Children\u2019s Hospital, Toledo, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Neonatology, ProMedica Toledo Children\u2019s Hospital, Toledo, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele C.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Pediatrics, University Hospitals Rainbow Babies and Children\u2019s Hospital and Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,10,1]]},"reference":[{"key":"2021120908425788300_B1","volume-title":"Neonatal Abstinence Syndrome and Drug Use Among Pregnant Women in Ohio, 2004\u20132011","author":"Massatti","year":"2013"},{"key":"2021120908425788300_B2","article-title":"Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012.","author":"Patrick","journal-title":"J Perinatol"},{"issue":"22","key":"2021120908425788300_B3","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1056\/NEJMsa1500439","article-title":"Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs.","volume":"372","author":"Tolia","year":"2015","journal-title":"N Engl J Med"},{"key":"2021120908425788300_B4","unstructured":"SAMHSA. 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