Details:

Alternative Title:
J Subst Abuse Treat
Publisher's site:
http://dx.doi.org/10.1016/j.jsat.2021.108492|10.1176/appi.ajp.2011.10101476|10.1080/08897077.2020.1728466|10.1093/jamia/ocaa217|10.1001/jama.2018.8826|10.1176/appi.ajp.2020.20040454|10.1001/jamanetworkopen.2020.31640|10.1016/j.drugalcdep.2017.01.048|10.1089/tmj.2014.0152|10.1001/archgenpsychiatry.2010.129|10.1016/j.jsat.2013.08.009|10.1016/j.jsat.2008.06.011|10.1016/j.drugalcdep.2014.12.019|10.1001/jamapsychiatry.2016.1390|10.1111/add.15116|10.1016/j.jsat.2019.03.007|10.1111/ajad.12553|10.1002/14651858.CD002207.pub4|10.1016/j.jsat.2017.07.001|10.1001/jama.2017.0001|10.1016/j.jsat.2017.01.015|10.1016/j.drugalcdep.2011.10.004|10.1097/ADM.0000000000000245|10.1111/ajad.12861|10.1001/jama.2015.10345|10.1097/MLR.0b013e31819432e5|10.1111/ajad.12805|10.1016/j.drugalcdep.2004.08.003|10.1080/08897077.2018.1452327|10.1097/ADM.0000000000000287
Personal Author:
Lin, Lewei A. ; Fortney, John ; Bohnert, Amy S.B. ; Coughlin, Lara N. ; Zhang, Lan ; ... More +
Lin, Lewei A. ; Fortney, John ; Bohnert, Amy S.B. ; Coughlin, Lara N. ; Zhang, Lan ; Piette, John D. Less -
Description:
Background:

Telemedicine-delivered buprenorphine (tele-buprenorphine) can potentially increase access to buprenorphine for patients with opioid use disorder (OUD), especially during the COVID-19 pandemic, but we know little about use in clinical care.

Methods:

This study was a retrospective national cohort study of veterans diagnosed with opioid use disorder (OUD) receiving buprenorphine treatment from the Veterans Health Administration (VHA) in fiscal years 2012–2019. The study examined trends in use of tele-buprenorphine and compared demographic and clinical characteristics in patients who received tele-buprenorphine versus those who received in-person treatment only.

Results:

Utilization of tele-buprenorphine increased from 2.29% of buprenorphine patients in FY2012 (n=187) to 7.96% (n=1352) in FY2019 in VHA veterans nationally. Compared to patients receiving only in-person care, tele-buprenorphine patients were less likely to be male (AOR=0.85, 95% CI: 0.73–0.98) or Black (AOR=0.54, 95% CI:0.45–0.65). Tele-buprenorphine patients were more likely to be treated in community-based outpatient clinics rather than large medical centers (AOR=2.91, 95% CI: 2.67–3.17) and to live in rural areas (AOR=2.13, 95% CI:1.92–2.35). The median days supplied of buprenorphine treatment was 722 (interquartile range: 322–1459) among the tele-buprenorphine patients compared to 295 (interquartile range: 67–854) among patients who received treatment in-person.

Conclusions:

Use of telemedicine to deliver buprenorphine treatment in VHA increased 3.5-fold between 2012 and 2019, though overall use remained low prior to COVID-19. Tele-buprenorphine is a promising modality especially when treatment access is limited; however, we must continue to understand how practitioners and patient are using telemedicine and how these patients’ outcomes compare to those using in-person care.


Subject:
[+]
Article
Buprenorphine
Cohort Studies
COVID-19
Humans
Male
Opiate Substitution Treatment
Opioid-Related Disorders
Opioid Use Disorder
Pandemics
Retrospective Studies
SARS-CoV-2
Telehealth
Telemedicine
Veterans

Source:
J Subst Abuse Treat. 133:108492
Pubmed ID:
34175175
Pubmed Central ID:
PMC8627529
Document Type:
Journal Article
Funding:
EP-C-18-008/EPA/EPAUnited States/ ; IK2 HX002612/HX/HSRD VAUnited States/ ; K23 AA028232/AA/NIAAA NIH HHSUnited States/ ; R49 CE003085/CE/NCIPC CDC HHSUnited States/
EP-C-18-008/EPA/EPAUnited States/ ; IK2 HX002612/HX/HSRD VAUnited States/ ; K23 AA028232/AA/NIAAA NIH HHSUnited States/ ; R49 CE003085/CE/NCIPC CDC HHSUnited States/ Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d0100ec1ca426ebd851b2183a27a1b0b3616382f28d3353beaa5fc1e907105af
File Type:

Supporting Files

• 	nihms-1711157-f0001.gif	gif
  	nihms-1711157-f0001.jpg	jpeg
  	nihms-1711157-f0002.gif	gif
  	nihms-1711157-f0002.jpg	jpeg
  	nihms-1711157.nxml	xml
  	NIHMS1711157-supplement-1.docx	docx

More +