Use of Telehealth for Opioid Use Disorder Treatment in Safety Net Primary Care Settings: A Mixed-Methods Study.
Subst Use Misuse
; 58(9): 1143-1151, 2023.
Article
em En
| MEDLINE
| ID: mdl-37170596
ABSTRACT
Background:
The COVID-19 pandemic resulted in a marked increase in telehealth for the provision of primary care-based opioid use disorder (OUD) treatment. This mixed methods study examines characteristics associated with having the majority of OUD-related visits via telehealth versus in-person, and changes in mode of delivery (in-person, telephone, video) over time.Methods:
Logistic regression was performed using electronic health record data from patients with ≥1 visit with an OUD diagnosis to ≥1 of the two study clinics (Rural Health Clinic; urban Federally Qualified Health Center) and ≥1 OUD medication ordered from 3/8/2020-9/1/2021, with >50% of OUD visits via telehealth (vs. >50% in-person) as the dependent variable and patient characteristics as independent variables. Changes in visit type over time were also examined. Inductive coding was used to analyze data from interviews with clinical team members (n = 10) who provide OUD care to understand decision-making around visit type.Results:
New patients (vs. returning; OR = 0.47;95%CI0.27-0.83), those with ≥1 psychiatric diagnosis (vs. none; OR = 0.49,95%CI0.29-0.82), and rural clinic patients (vs. urban; OR = 0.05; 95%CI0.03-0.08) had lower odds of having the majority of visits via telehealth than in-person. Patterns of visit type varied over time by clinic, with the majority of telehealth visits delivered via telephone. Team members described flexibility for patients as a key telehealth benefit, but described in-person visits as more conducive to building rapport with new patients and those with increased psychological burden.Conclusion:
Understanding how and why telehealth is used for OUD treatment is critical for ensuring access to care and informing OUD-related policy decisions.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Telemedicina
/
COVID-19
/
Transtornos Relacionados ao Uso de Opioides
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article