REMOTE: tREatMent for Opioid use via TElemedicine
远程:通过远程医疗治疗阿片类药物使用
基本信息
- 批准号:10463834
- 负责人:
- 金额:$ 23.1万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-15 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAppointmentBackBuprenorphineCOVID-19COVID-19 pandemicCaringCessation of lifeCharacteristicsClinicClinicalDangerousnessDataDiagnosisDrug ScreeningEconomicsEffectivenessElectronic Health RecordEmergency SituationEnsureEpidemicExerciseFaceFamily PracticeFederal GovernmentFederally Qualified Health CenterFoundationsFutureHealth ServicesHealth Services AccessibilityHealthcareInsuranceInsurance CarriersInterventionInterviewMedicalMethodsModalityNational Institute of Drug AbuseOpioidOverdosePatient MonitoringPatientsPatternPersonsPharmaceutical PreparationsPopulationPrimary Health CareProfessional RoleProviderRQ2RandomizedRegulationReportingResearchResourcesRiskRuralRural Health CentersSafetyStructureSubstance Use DisorderTelemedicineTelephoneUnderserved PopulationUrineVisitVulnerable PopulationsWorkauthoritybarrier to carebasebehavioral healthcare deliveryeffectiveness trialexperiencehealth care availabilityimplementation trialinnovationinterestlow socioeconomic statusmembermortalityopioid epidemicopioid policyopioid useopioid use disorderpandemic diseasepost-COVID-19primary care settingrandomized trialremote deliveryremote therapyremote visitresponserural areasafety and feasibilitysocialstressorsubstance use treatmenttreatment programtreatment servicestrial designvideo visit
项目摘要
PROJECT SUMMARY
The opioid epidemic is escalating during the coronavirus disease 2019 (COVID-19) pandemic. During 2018,
drug overdoses resulted in 67,367 deaths, with almost 70% involving an opioid. Preliminary data from 2019
show a rise of 4.8% in overdoses from 2018 and with the exacerbations of the COVID-19 pandemic, many
states are reporting further increases in opioid-related mortality in 2020. This is likely due to increased social
and economic stressors, as well as to limited treatment access, particularly among our most vulnerable
populations. Opioid use disorder (OUD) treatment has historically been delivered in person, as federal
regulations prohibited prescribing of buprenorphine via telemedicine (e.g., video or telephone) and remote
visits were rarely covered by insurance providers. During the pandemic, many insurers began covering
telemedicine visits and the federal government exercised authority to allow for the comprehensive treatment of
OUD via telemedicine. The option for telemedicine visits could increase OUD treatment accessibility and
engagement, particularly among those living in rural areas or whose resources are limited; however, limited
research exists on the impact of telemedicine on OUD treatment in primary care settings. We leverage this
unprecedented opportunity to study the impact of telemedicine on OUD treatment in primary care settings.
Study clinics include two Family Medicine clinics with established OUD treatment programs. These clinics (one
rural health center and one federally-qualified health center) serve patients that often face barriers to
healthcare access; thus, these are priority populations to study. The aims of this sequential explanatory mixed
methods study are as follows: Aim 1: Use electronic health record data to examine telemedicine versus face-
to-face visits for OUD-related treatment (e.g., diagnosis, visits with medical provider, behavioral health visits,
medication orders, appointment no shows, urine drug screens) before, during, and after implementation of
telemedicine; Aim 2: Conduct semi-structured qualitative interviews to assess how patients and clinical team
members experience OUD treatment that is delivered via telemedicine modalities. We use qualitative data to
further explain the patterns of treatment access and engagement observed in Aim 1 analyses. These findings
will inform best practices for remote OUD treatment delivery, whether for long-term sustainability post-
pandemic or in response to future emergency situations when in-person visits are not possible. Our findings
also lay the foundation for a randomized implementation and effectiveness trial designed to advance access to
treatment of OUD among those most in need. This study is highly responsive to the National Institute on Drug
Abuse (NIDA)'s Notice of Special Interest (NOSI) in the utilization of telemedicine to develop and support
treatments for substance use disorder among patients with or at risk of limitations of mobility (e.g., rural and
low SES populations).
项目摘要
在2019冠状病毒病(COVID-19)大流行期间,阿片类药物的流行正在升级。2018年期间,
药物过量导致67,367人死亡,其中近70%涉及阿片类药物。2019年的初步数据
自2018年以来,过量用药增加了4.8%,随着COVID-19大流行的加剧,许多
各国报告称,2020年类阿片相关死亡率将进一步上升。这可能是由于社会
经济压力,以及有限的治疗机会,特别是在我们最脆弱的人群中,
人口。阿片类药物使用障碍(OUD)治疗历来是亲自提供的,因为联邦
法规禁止通过远程医疗开出丁丙诺啡的处方(例如,视频或电话)和远程
医疗保险公司很少支付探视费用。疫情期间,许多保险公司开始承保
远程医疗访问和联邦政府行使权力,允许全面治疗
通过远程医疗。远程医疗访问的选择可以增加OUD治疗的可及性,
参与,特别是生活在农村地区或资源有限的人;然而,
在初级保健环境中,对远程医疗对OUD治疗的影响进行了研究。我们利用这个
这是一个前所未有的机会,可以研究远程医疗对初级保健环境中OUD治疗的影响。
研究诊所包括两个已建立OUD治疗计划的家庭医学诊所。这些诊所(1个
农村健康中心和一个联邦合格的健康中心)为经常面临障碍的患者提供服务,
因此,这些是研究的优先人群。这种顺序解释的目的是混合的
方法研究如下:目的1:使用电子健康记录数据来检查远程医疗与面对面医疗。
OUD相关治疗的面对面访视(例如,诊断,与医疗提供者的访问,行为健康访问,
药物订单,预约没有显示,尿液药物屏幕)之前,期间,和之后的实施
远程医疗;目标2:进行半结构化定性访谈,以评估患者和临床团队
成员体验通过远程医疗方式提供的OUD治疗。我们使用定性数据,
进一步解释目标1分析中观察到的治疗获得和参与模式。这些发现
将为远程OUD治疗提供最佳实践,无论是长期可持续性,
在大流行病期间,或在无法亲自访问时应对未来的紧急情况。我们的研究结果
也为随机实施和有效性试验奠定了基础,
在最需要的人群中治疗OUD。这项研究是高度响应国家药物研究所
滥用(NIDA)的特别利益通知(NOSI)在利用远程医疗发展和支持
在具有或处于活动受限风险的患者中治疗物质使用障碍(例如,农村和
低社会经济地位人口)。
项目成果
期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Use of Telehealth for Opioid Use Disorder Treatment in Safety Net Primary Care Settings: A Mixed-Methods Study.
在安全网初级保健环境中使用远程医疗治疗阿片类药物使用障碍:一项混合方法研究。
- DOI:10.1080/10826084.2023.2212378
- 发表时间:2023
- 期刊:
- 影响因子:2
- 作者:Bailey,SteffaniR;Wyte-Lake,Tamar;Lucas,JenniferA;Williams,Shannon;Cantone,RebeccaE;Garvey,BrianT;Hallock-Koppelman,Laurel;Angier,Heather;Cohen,DeborahJ
- 通讯作者:Cohen,DeborahJ
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Steffani R Bailey其他文献
Steffani R Bailey的其他文献
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{{ truncateString('Steffani R Bailey', 18)}}的其他基金
ASSIST: Assessment of Medicaid policy on Smoking Cessation Assistance and Surgical Outcomes
ASSIST:评估有关戒烟援助和手术结果的医疗补助政策
- 批准号:
10797988 - 财政年份:2023
- 资助金额:
$ 23.1万 - 项目类别:
Remotely Observed Methadone Evaluation (ROME)
远程观察美沙酮评估 (ROME)
- 批准号:
10774067 - 财政年份:2023
- 资助金额:
$ 23.1万 - 项目类别:
Remotely Observed Methadone Evaluation (ROME)
远程观察美沙酮评估 (ROME)
- 批准号:
10483876 - 财政年份:2022
- 资助金额:
$ 23.1万 - 项目类别:
CONNECT: COmpreheNsive traiNing and Engagement in Cessation Treatment
连接:戒烟治疗的综合培训和参与
- 批准号:
10430246 - 财政年份:2021
- 资助金额:
$ 23.1万 - 项目类别:
CONNECT: COmpreheNsive traiNing and Engagement in Cessation Treatment
连接:戒烟治疗的综合培训和参与
- 批准号:
10295696 - 财政年份:2021
- 资助金额:
$ 23.1万 - 项目类别:
REMOTE: tREatMent for Opioid use via TElemedicine
远程:通过远程医疗治疗阿片类药物使用
- 批准号:
10283155 - 财政年份:2021
- 资助金额:
$ 23.1万 - 项目类别:
Meaningful Use and Treatment of Smoking in Federally-Qualified Health Centers
在联邦合格的健康中心有意义地使用和治疗吸烟
- 批准号:
9198217 - 财政年份:2015
- 资助金额:
$ 23.1万 - 项目类别:
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