Telemedicine for Treatment of Opioid Use Disorder

治疗阿片类药物使用障碍的远程医疗

• 批准号: 10152467
• 负责人: HAIDEN A. HUSKAMP
• 金额: $ 91.31万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10152467
• 关键词: Address; Adoption; Alcohol consumption; American; Buprenorphine; Caring; Characteristics; Clinical; Communities; Congresses; Data; Disease; Disease model; Drug Addiction; Enrollment; Epidemic; Evaluation; Evidence based treatment; Goals; Growth; Health; Improve Access; Individual; Insurance; Internet; Interview; Knowledge; Laws; Machine Learning; Measures; Medicaid; Medicare; Mental disorders; Methadone; Methods; Modeling; Naltrexone; Patients; Persons; Pharmaceutical Preparations; Play; Policies; Privacy; Provider; Quality of Care; Recommendation; Regulation; Research; Role; Series; Speed; Structure; Substance Use Disorder; Telemedicine; Time; Transportation; Treatment Efficacy; United States Food and Drug Administration; Variant; Visit; Work; base; combat; design; improved; improved outcome; interest; machine learning method; methamphetamine use; opioid epidemic; opioid mortality; opioid use disorder; physically handicapped; programs; randomized trial; rural area; screening; treatment duration

PROJECT SUMMARY: A key challenge in combating the opioid epidemic has been connecting individuals with opioid use disorder to evidence-based treatments. The President's Commission on Combating Drug Addiction and the Opioid Crisis and others have suggested that telemedicine for substance use disorder (“tele- SUD”) may be part of the solution. In preliminary analyses, we have found that tele-SUD use is growing rapidly, and there is widespread policy interest in Congress and state legislatures in how to accelerate this growth. The SUPPORT for Patients and Communities Act, signed into law in October 2018, includes several provisions intended to reduce barriers to tele-SUD use and will likely increase the availability of and reimbursement for tele-SUD. However, despite the widespread interest and growing use, there has never been a rigorous assessment of tele-SUD. For example, what are the different tele-SUD models being used to treat opioid use disorder, what barriers exist to greater use of tele-SUD, and is tele-SUD use associated with improved (or potentially worse) quality of care for people with opioid use disorder? To fill this knowledge gap, we propose a comprehensive national evaluation of telemedicine for opioid use disorder using data through 2021 from Medicaid, Medicare, and commercial insurance as well as a series of qualitative interviews. Our Aims are to: (1) describe the different models of how tele-SUD is being incorporated into opioid use disorder care and how this is changing over time, (2) identify regional factors associated with greater tele-SUD use for opioid use disorder, (3) examine the association between tele-SUD use and quality of opioid use disorder care received and whether this varies by model, and (4) describe existing tele-SUD programs, and identify barriers and facilitators to tele-SUD adoption and sustainability. The proposed mixed-methods study will help providers interested in using tele-SUD and inform ongoing debates about regulations and reimbursement for tele-SUD in Congress and state legislatures. Our goal is to highlight policies and practices that drive greater use of tele-SUD and explore its potential role in improving access to, and quality of, care for individuals with opioid use disorder. Our research will help inform how tele- SUD may be leveraged to combat the opioid epidemic as well as other substance use disorders, such as alcohol and methamphetamine use disorders.

项目摘要：抗击阿片类药物流行病的一个关键挑战是将个人联系起来 患有阿片类药物使用障碍的循证治疗。总统禁毒委员会 成瘾和阿片类药物危机等人建议，针对物质使用障碍的远程医疗（“远程医疗”） SUD”）可能是解决方案的一部分。在初步分析中，我们发现远程 SUD 的使用正在增长 国会和州立法机构对如何加速这一进程存在广泛的政策兴趣 生长。 《患者和社区支持法案》于 2018 年 10 月签署成为法律，其中包括多项内容 旨在减少远程 SUD 使用障碍的规定，并可能增加 电话 SUD 报销。然而，尽管引起了广泛的兴趣和不断增长的使用，但从未有过 对远程 SUD 的严格评估。例如，用于治疗的不同 tele-SUD 模型有哪些？ 阿片类药物使用障碍，更多使用远程 SUD 存在哪些障碍，以及远程 SUD 的使用与 改善（或可能恶化）阿片类药物使用障碍患者的护理质量？为了填补这一知识空白， 我们建议使用以下数据对阿片类药物使用障碍的远程医疗进行全面的国家评估： 2021 年来自医疗补助、医疗保险和商业保险以及一系列定性访谈。我们的 目的是：(1) 描述如何将远程 SUD 纳入阿片类药物使用障碍的不同模型 护理以及这种情况如何随时间变化，(2) 确定与更多使用远程 SUD 相关的区域因素 阿片类药物使用障碍，(3) 检查远程 SUD 使用与阿片类药物使用障碍护理质量之间的关联 收到的信息以及这是否因型号而异，以及 (4) 描述现有的远程 SUD 计划，并识别障碍 以及远程 SUD 采用和可持续性的促进者。 拟议的混合方法研究将帮助有兴趣使用远程 SUD 的提供商，并为正在进行的研究提供信息 国会和州立法机构对远程 SUD 的法规和报销进行了辩论。我们的目标是 重点介绍推动更多使用远程 SUD 的政策和实践，并探讨其在改进电信 SUD 方面的潜在作用 阿片类药物使用障碍患者获得护理的机会和质量。我们的研究将有助于了解如何远程 SUD 可用于对抗阿片类药物流行以及其他物质使用障碍，例如 酒精和甲基​​苯丙胺使用障碍。