Telemedicine by phone and video is proving to be a lifeline for opioid addicted veterans

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Many hurdles stand in the way of effective treatment for people addicted to opioids.

But a new study shows that the prevalence of telemedicine is helping more people get treatment, even during the pandemic.

A national study examined the care received by veterans who received buprenorphine. opioid use disorder Both before and after the pandemic, care shifted to telemedicine in early 2020.

Virtual visits with addiction care providers show that many patients were able to stay on medication to support recovery throughout the first year of the pandemic.

It also shows an important role for phone-only visits in these patients. Through 2020, audio visits far outstripped both video and in-person visits. And even in early 2021, phone calls still accounted for half of monthly veterans’ buprenorphine-related visits, with video visits accounting for 32% and in-person visits accounting for 32%. Care is 17%.

On a monthly basis, 14% more veterans were receiving buprenorphine treatment in February 2021 compared to March 2019. Over the same period, the total number of veterans receiving any form of addiction treatment decreased by 6%.

This research American Journal of Psychiatry A team from the University of Michigan and VA Ann Arbor Healthcare System. The lead author is Allison Lin, MD, MS, an addiction psychiatrist and researcher at the Michigan Medical Addiction Center, UM’s Academic Medical Center, and Her VA Center for Clinical Management Research. .

Notice of Telemedicine Policy

New phone, video, and face-to-face treatment data could help inform key policy issues currently being debated.

Policy makers are grappling with the potential to replace not just the VA system, but a temporary pandemic-era emergency telemedicine policy for patients nationwide. Before the pandemic, audio-only visits were generally not allowed, and video visits to patients at home were often not reimbursed.

Policy makers need to weigh the evidence carefully before crafting the final rule, says Lin.

“Telemedicine for patients receiving buprenorphine for opioid use disorder was relatively new in VAs nationwide prior to the outbreak of the pandemic, allowing only video. The rapid turnover has kept people from dropping out of care, and the phone visits have played a big role – a key role,” she says. “Thanks to the Department of Veterans Affairs’ National Patient Data System, we were able to gain a first understanding of phone, video and in-person visits before and during the pandemic.”

Phone access can be especially important for people with opioid use disorders, who often lack access to stable housing, high-speed internet, or computers, she notes.

“Telephone visits may provide flexibility that makes it easier for people to stay engaged in care over the long term,” she says. They are also some of the sickest patients we are treating, and continuing to care for these patients is a top priority.”

Policies that make it easier for them to continue with addiction care can have a significant impact on their overall outcomes, says a member of the UM Institute for Healthcare Policy and Innovation and the UM Injury Prevention Center. Lin adds.

“Anecdotally, some clinics have seen a decline in no-shows over the past two years as they have been able to use phones and video,” she said. “Throughout the pandemic, it has been assumed that we must return to what we were before COVID-19. But this may be a case of trying to get back to in-person care if you don’t want to go. Or banning virtual visits can have unintended effects.If policies don’t allow flexibility and don’t offer options, you could lose people who only knew care by phone or video. I have.

Next step

In addition to this study, Lin says further research is critically needed to understand the experiences and preferences of patients and clinicians and to further assess the quality of care telemedicine provides.

“The goal is to determine what high-quality care looks like, both telemedicine and in person, to inform the standards in this area, but that will take time.

In the meantime, efforts to improve access to buprenorphine treatment must continue.

“Addiction is the only disease we have in all of medicine, and the condition itself makes it difficult for people to seek treatment,” she points out. The transition to health care has not removed other barriers to care, and it will take longer to actually reach those who need effective OUD care.”

Lin and her UM colleague Dr. Erin Bonar, an addiction psychologist and researcher, are addressing just that question in their current study.

Rather than waiting for patients to seek addiction treatment, their team is exploring ways to reach out and provide treatment to patients through telemedicine. This goes beyond past studies that left patients to make phone calls to get treatment.

The results of the pilot study of this program have been very encouraging, and we are currently testing the program in two full-scale randomized controlled trials sponsored by the National Institutes of Health.

“Addiction care and research is often focused on patients who are seeking treatment and have already opened the door. But that is the minority of patients with substance use disorders,” said Lynn. “Now that we have witnessed the power of telemedicine to support recovery, we need to reach out to more people who can benefit from care. I have. Addiction Much easier to care and meet people wherever they are. “

In addition to this effort, Lin collaborated with others to A free toolkit to ensure providers deliver high-quality buprenorphine Care and Other Treatments for Opioid Use Disorders. Available from Provider Clinical support system Funded by the Federal Substance Abuse and Mental Health Services Administration. The recent relaxation of federal rules for health care providers wishing to prescribe buprenorphine More providers can do that.

Voice-only telemedicine is still common in safety net clinics

For more information:
Impact of COVID-19 Telemedicine Policy Changes on Buprenorphine Treatment for Opioid Use Disorder, American Journal of Psychiatry (2022). DOI: 10.1176/appi.ajp.21111141

Quote: Telemedicine with Phone and Video Proves a Lifeline for Opioid Addicted Veterans (28 July 2022) 28 July 2022 Taken from -telehealth-video-lifeline-veterans-opioid.html

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Telemedicine by phone and video is proving to be a lifeline for opioid addicted veterans

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