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: 10463834
• 负责人: Steffani R Bailey
• 金额: $ 23.1万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 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: https://reporter.nih.gov/project-details/10463834
• 关键词: Address; Appointment; Back; Buprenorphine; COVID-19; COVID-19 pandemic; Caring; Cessation of life; Characteristics; Clinic; Clinical; Dangerousness; Data; Diagnosis; Drug Screening; Economics; Effectiveness; Electronic Health Record; Emergency Situation; Ensure; Epidemic; Exercise; Face; Family Practice; Federal Government; Federally Qualified Health Center; Foundations; Future; Health Services; Health Services Accessibility; Healthcare; Insurance; Insurance Carriers; Intervention; Interview; Medical; Methods; Modality; National Institute of Drug Abuse; Opioid; Overdose; Patient Monitoring; Patients; Pattern; Persons; Pharmaceutical Preparations; Population; Primary Health Care; Professional Role; Provider; RQ2; Randomized; Regulation; Reporting; Research; Resources; Risk; Rural; Rural Health Centers; Safety; Structure; Substance Use Disorder; Telemedicine; Telephone; Underserved Population; Urine; Visit; Vulnerable Populations; Work; authority; barrier to care; base; behavioral health; care delivery; effectiveness trial; experience; health care availability; implementation trial; innovation; interest; low socioeconomic status; member; mortality; opioid epidemic; opioid policy; opioid use; opioid use disorder; pandemic disease; post-COVID-19; primary care setting; randomized trial; remote delivery; remote therapy; remote visit; response; rural area; safety and feasibility; social; stressor; substance use treatment; treatment program; treatment services; trial design; video visit

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).

项目总结

项目成果

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: Substance use & misuse
• 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