Telemedicine for Treatment of Opioid Use Disorder: NIDA Summer Research Internship Program

项目摘要：抗击阿片类药物流行的一个关键挑战是将个人 从阿片类药物使用障碍到循证治疗。总统禁毒委员会 成瘾和阿片类药物危机以及其他方面表明，远程医疗治疗物质使用障碍(“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Tele-sud的使用正在增长 迅速，国会和州立法机构对如何加快这一进程产生了广泛的政策兴趣 成长。2018年10月签署成为法律的《患者和社区支持法案》包括几项 旨在减少使用Tele-Sud的障碍的规定，并可能增加和 TELE-SUD的报销。然而，尽管受到了广泛的关注和越来越多的使用，但从来没有 对Tele-Sud进行了严格的评估。例如，用于治疗的不同Tele-Sud模型是什么 阿片类药物使用障碍，更多地使用tele-sud存在哪些障碍，tele-sud的使用与 改善(或可能更差)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采访。我们的 目的是：(1)描述tele-sud如何被纳入阿片类药物使用障碍的不同模型 注意这一点以及这种情况随着时间的推移是如何变化的，(2)确定与更多使用远程医疗相关的地区因素 阿片类药物使用障碍，(3)检查电话使用与阿片类药物使用障碍护理质量之间的关系 (4)描述现有的Tele-Sud计划，并确定障碍 和促进者，以促进采用和可持续性。 拟议的混合方法研究将帮助有兴趣使用tele-sud的供应商，并告知正在进行的 国会和州立法机构关于Tele-Sud的法规和补偿的辩论。我们的目标是 强调推动更多使用tele-sud的政策和做法，并探讨其在改进 获得阿片类药物使用障碍患者护理的机会和质量。我们的研究将有助于了解电视是如何 可以利用SUD来防治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。

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.