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Table 1 Standardized Patient Profiles

From: Development of an unannounced standardized patient protocol to evaluate opioid use disorder treatment in pregnancy for American Indian and rural communities

  White/Caucasian American Indian (Navajo)
Demographic information
 Name Leah Lapinski Sasha Tso
 Birth date 12/04/1997
 Age 22
 Relationship Boyfriend, 1 child (age 2)
 Employment Not working/unemployed
 Insurance Medicaid
Personal information
 Address [vacant property in nearest municipality to clinic]
OR
[unavailable; staying with friend, moving to apartment]
 Phone [borrowing from a friend]
 Email trailwanderer95@gmail.com
 Previous provider “Dr. Patel”
 Chief complaint New prenatal care
Patient concerns • Heroin relapse
• Loss of child custody
• Becoming suicidal again
• Health/wellbeing of new baby
• Financial stress/unemployment
Background
 Recent relocation from Denver, CO Navajo Nation
(Window Rock, AZ)
 Medical history Chronic neck pain
• after motor vehicle accident ~ 7 years ago, treated with oxycodone for several years
Opioid use disorder
• arising from chronic oxycodone use, was aggressively tapered by previous provider, began using IV heroin
• During pregnancy of first child, sought OUD treatment, started on Suboxone, child was hospitalized for 6 weeks with neonatal abstinence syndrome
• Had one relapse with heroin for 2 months, has been stable on Suboxone without relapse for last 12 months
Depression
• Treated medically by PCP for last 4 years
• 1 suicide attempt (oxycodone overdose) about 4 years ago
 Allergies None
 Medications Suboxone 8 mg/2 mg BID
Zoloft 100 mg/day
Prenatal vitamin
 Immunizations “up to date”
Set-up instructions (clinic visit only)
 Clothing Elastic exercise pants, dingy t-shirt, coat/jacket, disheveled hair
 Equipment Backpack, smart phone, snack (in backpack) Backpack with attached dreamcatcher, smart phone, snack (in backpack)
 Position Sitting in chair (or on exam table if no chair available)
Symptoms (clinic visit only) • Occasional neck spasms/pain, 6/10, sometimes improves a little with Motrin
• Depressed/anxious: worried about pregnancy, finances/unemployment
• No suicidality