A qualitative exploration of the use of telehealth for opioid treatment: Implications for nurse-managed care.

ABSTRACT

AIM: To characterise experiences with telehealth for Medications for Opioid Use Disorder (MOUD) services among patients, prescribers, nurses and substance use counsellors to inform future best practices. DESIGN: We engaged a qualitative descriptive study design. METHODS: Semi-structured interviews were conducted with prescribers (nurse practitioners and physicians, n = 20), nurses and substance use counsellors (n = 7), and patients (n = 20) between June and September 2021. Interviews were verbatim transcribed. Thematic analysis was conducted using a qualitative descriptive method. RESULTS: Among both providers and patients, four themes were identified (1) Difficulties with telehealth connection (2) Flexibility in follow-up and retention, (3) Policy changes that enabled expanded care, (4) Path forward with telehealth. Two additional findings emerged from provider interviews (1) Expansion of nurse-managed office-based opioid treatment, and (2) Novel methods to engage patients. CONCLUSIONS: Patients and providers continued to view telehealth as an acceptable means for delivery and management of MOUD, particularly when utilised in a hybrid manner between in-person visits. Nurse-managed care for this service was evident as nurses extended the breadth of services offered and utilised novel methods such as text messages and management of 'call-in' lines to engage patients. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Use of telehealth for MOUD should be incorporated into practice settings to reach patients in a flexible manner. Nurses in particular can use this medium to extend office-based opioid treatment by conducting assessments and expanding capacity for other wrap-around services. IMPACT We identify recommendations for best practices in the use of telehealth for opioid use disorder management and highlight the value of nurse-managed care. REPORTING METHOD: The consolidated criteria for reporting qualitative research. PATIENT OR PUBLIC CONTRIBUTION Patients with opioid use disorder and prescribers with experience using telehealth were interviewed for this study.