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: 10169552
• 负责人: HAIDEN A. HUSKAMP
• 金额: $ 17.46万
• 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/10169552
• 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：打击Ooid流行病的一个主要挑战一直在与个体联系在一起 与烯烃使用障碍与循证疗法有关。总统打击毒品委员会 成瘾和阿片类药物危机和其他人都建议远程医疗用于药物使用障碍（“ tele- SUD”）可能是解决方案的一部分。在初步分析中，我们发现电视使用正在增长 迅速，国会和州立法机关在如何加速这一方面存在广泛的政策利益 生长。 2018年10月签署的《患者和社区法》的支持法案包括几个 旨在减少电视使用障碍的规定，可能会增加和 报销电视。但是，尽管兴趣广泛和使用越来越大，但从未有过 严格的电视评估。例如，用于治疗的不同电视模型是什么 Opioid使用障碍，有哪些障碍可以更好地使用电视，并且与远程使用有关 改善了阿片类药物使用障碍患者的护理质量（或可能更糟）？为了填补这一知识差距， 我们建议使用通过 2021年，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）描述如何将电信纳入阿片类药物使用障碍的不同模型 （2）确定与更大的电视使用相关的区域因素，这是如何变化的 OPIOED使用障碍，（3）检查远程使用和蛋白质使用障碍护理质量之间的关联 收到以及该模型是否有所不同，（4）描述现有的电视节目，并确定障碍 以及促进电视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Tele-Sud的提供商并告知正在进行的 关于国会和州立法机关中电视的法规和报销的辩论。我们的目标是 突出显示了推动更多使用电信并探索其在改善中的潜在作用的政策和实践 访问阿片类药物使用障碍患者的护理和质量。我们的研究将有助于告知电信 SUD可能被杠杆作用以对抗阿片类药物流行病以及其他物质使用障碍，例如 酒精和甲基​​苯丙胺使用障碍。