Implementation of Telemedicine Delivery of Medications for Opioid Use Disorder in Pennsylvania Treatment Programs During COVID-19.
Implementation of Telemedicine Delivery of Medications for Opioid Use Disorder in Pennsylvania Treatment Programs During COVID-19.
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COVID-19 期间，在宾夕法尼亚州治疗计划中实施远程医疗治疗阿片类药物使用障碍药物。
DOI：
10.1097/adm.0000000000001079
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发表时间：
2023
影响因子：
5.5
通讯作者：
Colistra,Angela
中科院分区：
文献类型：
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作者：
Poulsen,MelissaN;Santoro,William;Scotti,Roseanne;Henderson,Catherine;Ruddy,Meaghan;Colistra,Angela
方法5个拥有远程医疗模式的卫生系统完成了远程医疗模式的问卷调查，并提供了2020年现场和远程医疗就诊的MOUD患者的汇总社会人口统计数据。三个项目提供了在远程模式扩大期间汇总的每月预约数据（已安排、已完成、未到诊、远程模式就诊）。结果远程用药方案的差异与提供远程用药诱导、患者是否符合远程用药条件和远程药物检测的实施有关。在整个项目中，88%的开处方者进行了远程医疗预约，50%的患者在2020年使用了远程医疗预约。我们观察到社会人口统计学上的差异，女性、白人和非西班牙裔患者使用远程mod的比例更大。在有预约数据的项目中，总体患者登记人数增加，新患者登记人数保持相对稳定。参与趋势表明，在一个项目中，与远程mod升级相一致的是，缺席预约的人数暂时下降。结论stelle - mod方案的差异表明需要研究为循证指导提供信息。研究结果表明，随着远程医疗的实施，患者在很大程度上仍然参与并保留了远程医疗服务，但也揭示了远程医疗服务使用中的不公平现象，强调需要努力克服技术获取障碍，避免加剧远程医疗服务获取的差异。
MethodsFive health systems with MOUD programs completed questionnaires regarding their tele-MOUD models and provided aggregated sociodemographic data for MOUD patients with in-person and telemedicine visits in 2020. Three programs provided aggregated monthly appointment data (scheduled, completed, no-show, tele-MOUD visits) over the period in which tele-MOUD scaled up.ResultsDifferences in tele-MOUD protocols related to provision of tele-MOUD inductions, patient eligibility for tele-MOUD, and operationalization of remote drug testing. Across programs, 88% of prescribers conducted tele-MOUD appointments, and 50% of patients used tele-MOUD in 2020. We observed sociodemographic differences, with a greater proportion of female, White, and non-Hispanic patients using tele-MOUD. Across programs with appointment data, overall patient enrollment increased, and new patient enrollment remained relatively constant. Engagement trends suggested a temporary decline in no-show appointments that aligned with the escalation of tele-MOUD in one program.ConclusionsTele-MOUD protocol differences indicate a need for research to inform evidence-based guidance. Findings suggest that patients largely remained engaged and retained in MOUD as tele-MOUD was implemented but reveal inequities in tele-MOUD use, highlighting the need for efforts to overcome technology access barriers and avoid exacerbating disparities in MOUD access.