A qualitative study of patient experiences with telemedicine opioid use disorder treatment during COVID-19
A qualitative study of patient experiences with telemedicine opioid use disorder treatment during COVID-19
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DOI：
10.1080/08897077.2022.2060447
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发表时间：
2022-12-01
期刊：
影响因子：
3.5
通讯作者：
Buchheit, Bradley M.
中科院分区：
文献类型：
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作者：
Lockard, Rachel;Priest, Kelsey C.;Buchheit, Bradley M.
背景：2019冠状病毒病大流行期间，与药物相关的过量用药危机恶化。在COVID-19期间，最近的药物政策变化增加了阿片类药物使用障碍（MOUD）药物的可及性，将一些门诊MOUD治疗转移到虚拟环境中，以减少对亲自护理的需求。本研究的目的是定性地探讨在提供丁丙诺啡和减少伤害服务的低阈值成瘾治疗诊所中，阿片类药物使用障碍患者在虚拟患者接触中的得失。研究方法：如果患者在2019年11月至2021年3月期间在伤害减少和护理桥梁（HRBR）诊所接受护理并使用虚拟访视，则将其纳入本研究。这项研究是概念化的使用保健服务的访问框架和以前的远程医疗可接受性的研究。半结构式访谈于2021年3月至4月期间完成。访谈进行了双重编码，并使用定向内容分析进行分析。结果：共进行了19次访谈。样本主要为白色（84%）和稳定圈养（79%），性别（男性，53%）和就业状况（就业，42%）相当。大多数（63%）患者更喜欢虚拟访视，而不是亲自访视（16%）或两者结合（21%）。出现了两个首要的串联领域：可用性-适应性和可接受性-适当性。便利性住宿反映了参与者对即时服务的渴望，并减少了交通和工作或安排日程的障碍，虚拟访问促进了这一点。可接受的适当领域阐明了参与者如何感觉到与其提供者的联系，无论是通过面对面的互动还是通过虚拟访问期间经历的相互信任。结论：虚拟访问被认为是一个有价值的和关键的选择访问治疗OUD的参与者。虽然许多参与者更喜欢虚拟访问，但由于与提供者的关系和物理互动，一些参与者更喜欢面对面的访问。参与者希望灵活性和能够根据自己的需要选择治疗方式。
Background: The drug-related overdose crisis worsened during the COVID-19 pandemic. Recent drug policy changes to increase access to medications for opioid use disorder (MOUD) during COVID-19 shifted some outpatient MOUD treatment into virtual settings to reduce the demand for in-person care. The objective of this study was to qualitatively explore what is gained and lost in virtual patient encounters for patients with opioid use disorder at a low-threshold, addiction treatment clinic that offers buprenorphine and harm reduction services. Methods: Patients were included in this study if they received care at the Harm Reduction and BRidges to Care (HRBR) clinic and utilized virtual visits between November 2019 and March 2021. The study was conceptualized using a health care access framework and prior studies of telemedicine acceptability. Semi-structured interviews were completed between March and April 2021. Interviews were dual-coded and analyzed using directed content analysis. Results: Nineteen interviews were conducted. The sample was predominantly White (84%) and stably housed (79%) with comparable gender (male, 53%) and employment status (employed, 42%). The majority (63%) of patients preferred virtual visits compared to in-person visits (16%) or a combination of access to both (21%). Two overarching tandem domains emerged: availability-accommodation and acceptability-appropriateness. Availability-accommodation reflected participants' desires for immediate services and reduced transportation and work or caregiving scheduling barriers, which was facilitated by virtual visits. The acceptable-appropriate domain articulated how participants felt connected to their providers, whether through in-person interactions or the mutual trust experienced during virtual visits. Conclusions: Virtual visits were perceived by participants as a valuable and critical option for accessing treatment for OUD. While many participants preferred virtual visits, some favored face-to-face visits due to relational and physical interactions with providers. Participants desired flexibility and the ability to have a choice of treatment modality depending on their needs.