Telehealth-Based Delivery of Medication-Assisted Treatment for Opioid Use Disorder: a Critical Review of Recent Developments.

PURPOSE OF REVIEW: Telehealth-delivered medication-assisted treatment for opioid use disorder (tele-MOUD) has received increased attention, with the intersection of the opioid epidemic and COVID-19 pandemic, but research on recent developments is scattered. We critically review recent literature on tele-MOUD and synthesize studies reporting primary data under four themes: clinical effectiveness, non-clinical effectiveness, perceptions, and regulatory considerations. RECENT FINDINGS: Despite increasing publications, most failed to include long-term comprehensive assessments. Findings indicate favorable outcomes such as improvements in retention and abstinence rates, positive experiences, and improved feasibility with the relaxation of regulatory measures. With increased adoption, clinician and patient perceptions appeared largely positive. Negative findings, albeit minor, were primarily associated with workflow adaptation difficulties and limited access of underserved populations to technology and internet connection. Additional financial, logistical, outreach, and training support for clinicians, patients, and support staff is recommended, in addition to permanent evidence-based regulatory reforms, to scale and optimize tele-MOUD services. Comprehensive recommendations to overcome limitations are expanded therein.

Addressing the Behavioral Health Needs of Sexual and Gender Minorities During the COVID-19 Pandemic: a Review of the Expanding Role of Digital Health Technologies.

PURPOSE OF REVIEW: To review the role of digital health technologies in behavioral health treatment and promotion for sexual and gender minorities (SGM). RECENT FINDINGS: Digital technologies have advantages and limitations at multiple levels in addressing SGM's behavioral health needs. For patients, digital technologies improve convenience and may reduce stigma; however, privacy concerns in the home may limit their utilization. Providers also benefit from the convenience of these technologies; however, not all providers are comfortable delivering virtual care to SGM. For society, digital technologies reduce transportation-related costs and increase access to healthcare in an increasingly hostile political climate for SGM; however, these advantages are limited by technological access and anti-SGM policies. Digital technologies can improve the behavioral health of SGM at the patient, provider, and systemic levels. Further efforts are necessary to standardize provider training, improve SUD-specific care delivery, and increase quality and accessibility of these technologies.

COVID-19 Pandemic Preparedness in Egypt's Teaching Hospitals: A Needs Assessment Study.

INTRODUCTION: Regular collection and monitoring of data describing the dynamics of the utilization of healthcare services, especially in teaching hospitals (TH), which provide model quality medical services, are critical for COVID-19 pandemic preparedness. METHODS: The researchers analyzed data and information derived from service statistics reports from June 1st to July 15th, 2020 in terms of hospital resources, as well as utilization patterns of beds, ICU, and ventilators, for 11 screening hospitals affiliated with the General Organization of Teaching Hospitals and institutes in Egypt assigned by the Ministry of Health and Population to provide medical care for COVID-19 patients. Hospital indicators in terms of COVID-19 screening services, as well as utilization patterns of inpatient beds, ICU beds, and ventilators were computed. RESULTS: A total of 78,869 non-medical personnel and 2,176 medical personnel were presented with COVID-19 triage symptoms. Investigations conducted in the targeted 11 hospitals delineated that 22.2% of non-medical personnel and 27.9% of medical personnel were COVID-19 PCR-confirmed cases. The inpatient bed occupancy rate was 70% for non-medical patients and 67% for medical staff patients. For ICU, the bed occupancy rate was 92 % for non-medical patients and 88% for medical patients. Among the confirmed cases, 38% of medical patients utilized a ventilator vs. 36% of medical personnel cases. Hospital ranking according to utilization pattern among non-medical personnel, Hospital H ranked first in terms of the high load of screening services. Hospital C ranked first regarding the number of confirmed cases, whereas Hospital D ranked first for high ICU utilization among all teaching hospital ICU cases. With respect to medical personnel, Hospital G ranked first for the high load of screening services for the total studied cases. Hospital G ranked first for the number of confirmed cases. Hospital B ranked first regarding high ICU utilization among all teaching hospital ICU cases. CONCLUSION: Teaching hospitals have demonstrated preparedness for the COVID-19 pandemic by maintaining an inpatient bed occupancy rate of 70% or less and ventilator utilization at <40% of confirmed cases. However, the ICU bed occupancy rate was more than 90% indicating a shortage of resources. In addition, there is variance across hospitals regarding caseload for resource reallocation decisions.

Guidelines for primary health care-based telemental health in a low-to middle-income country: the case of Lebanon.

Significant efforts have been conducted to improve access to Mental Health Services (MHS) and reduce the burden of Mental Health Disorders (MHD) in Low-to Middle-Income Countries (LMIC). However, important challenges to accessing MHS still exist and limit improvements. Telemental Health (TMH), a modality that delivers remote MHS provides an ideal solution to complement existing efforts; however, there are limited reports on its implementation in developing countries such as Lebanon. This study presents the first roadmap for TMH applicability in Lebanon, with a focus on the Primary Health Care (PHC) setting, which has international relevance. We review existing guidelines and contextualise them to the Lebanese setting by addressing essential components for implementation. In specific, we shed light on 6 aspects: (1) patient population, (2) technological guidelines, (3) clinical guidelines, (4) administrative guidelines, (5) workforce, and (6) monitoring and evaluation. In addition, we acknowledge the important role of governmental efforts in setting the infrastructural and regulatory aspects for TMH practice. We provide guidance for public health professionals, government officials, and clinicians looking to adopt TMH practice in Lebanon or other countries with similar development and cultural landscapes.