Impact of COVID-19 Telehealth Policy Changes on Buprenorphine Treatment for Opioid Use Disorder.
Impact of COVID-19 Telehealth Policy Changes on Buprenorphine Treatment for Opioid Use Disorder.
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DOI：
10.1176/appi.ajp.21111141
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发表时间：
2022-10
影响因子：
17.7
通讯作者：
Frost, Madeline C.
中科院分区：
文献类型：
--
作者：
Lin, Lewei (Allison);Zhang, M. S. Lan;Kim, Hyungjin Myra;Frost, Madeline C.
本研究考察了COVID-19政策对降低远程医疗提供丁丙诺啡治疗阿片类药物使用障碍（OUD）的障碍对不同方式（电话，视频，面对面）丁丙诺啡治疗的影响。我们进行了一项全国性回顾性队列研究，并进行了中断时间序列分析，以检查2020年3月的政策变化对退伍军人健康管理局在COVID-19前（2019年3月至2020年2月）和COVID-19后（2020年3月至2021年2月）期间丁丙诺啡治疗OUD的影响。我们还研究了电话、视频和亲自就诊进行丁丙诺啡治疗的趋势，并比较了COVID-19前后的患者人口统计学和丁丙诺啡保留率。接受丁丙诺啡治疗的患者人数由2019年3月的13，415人增加至2021年2月的15，339人。截至2021年2月，大多数患者（50.2%，4，456人）使用电话访问，其次是视频（32.4%，2，870人）和亲自访问（17.4%，1，544人）。在COVID-19之前，接受丁丙诺啡治疗的患者每月增加103例（p<0.001）。COVID-19政策变化后，第一个月立即增加了265名患者，人数继续增加，但每月增加47名患者（p<0. 001）。COVID-19后接受丁丙诺啡的患者与COVID-19前的患者具有相似的人口统计学特征，但丁丙诺啡达到90天保留的百分比从49.6%下降到47.7%（p<0.05），而丁丙诺啡的天数从203.8增加到208.7（p<0.001）。在COVID-19政策变化后，接受丁丙诺啡的患者数量继续增加，但交付转向远程医疗访问，这表明必须仔细考虑COVID-19政策的逆转。
This study examined the impact of COVID-19 policies reducing barriers to telehealth-delivered buprenorphine for opioid use disorder (OUD) on buprenorphine treatment across different modalities (phone, video, in-person). We conducted a national retrospective cohort study with interrupted time series analyses to examine the impact of policy changes in March 2020 on buprenorphine treatment for OUD in the Veterans Health Administration, during pre-COVID-19 (March 2019 to February 2020) and post-COVID-19 (March 2020 to February 2021) periods. We also examined trends in use of phone, video and in-person visits for buprenorphine treatment and compared patient demographics and buprenorphine retention across the pre- and post-COVID-19 periods. The number of patients receiving buprenorphine increased from 13,415 in March 2019 to 15,339 in February 2021. By February 2021, phone visits were used by the most patients (50.2%, 4,456), followed by video (32.4%, 2,870) and in-person (17.4%, 1,544). During the pre-COVID-19 period, patients receiving buprenorphine increased by 103 patients per month (p<0.001). Post-COVID-19 policy changes, there was an immediate increase of 265 patients in the first month and the number continued to increase but by 47 patients each month (p<0.001). Patients receiving buprenorphine post-COVID-19 had similar demographic characteristics to those pre-COVID-19, but percent reaching 90-day retention on buprenorphine decreased from 49.6% to 47.7% (p<0.05) while days on buprenorphine increased from 203.8 to 208.7 (p<0.001). The number of patients receiving buprenorphine continued to increase after COVID-19 policy changes, but the delivery shifted to telehealth visits, suggesting reversal of COVID-19 policies must be carefully considered.
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影响因子：
25.8
作者：
Lin LA;Fernandez AC;Bonar EE
通讯作者：
Bonar EE
影响因子：
4.4
作者：
Dupouy, Julie;Palmaro, Aurore;Lapeyre-Mestre, Maryse
通讯作者：
Lapeyre-Mestre, Maryse
影响因子：
3
作者：
Benjenk I;Franzini L;Roby D;Chen J
通讯作者：
Chen J
DOI：
10.1046/j.1365-2710.2002.00430.x
发表时间：
2002-08-01
影响因子：
2
作者：
Wagner, AK;Soumerai, SB;Ross-Degnan, D
通讯作者：
Ross-Degnan, D
影响因子：
3.2
作者：
Rodriguez, Jorge A.;Betancourt, Joseph R.;Ganguli, Ishani
通讯作者：
Ganguli, Ishani