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A Telemedicine Buprenorphine Clinic to Serve New York City: Initial Evaluation of the NYC Public Hospital System's Initiative to Expand Treatment Access During the COVID-19 Pandemic.
Tofighi, Babak; McNeely, Jennifer; Walzer, Dalia; Fansiwala, Kush; Demner, Adam; Chaudhury, Chloe S; Subudhi, Ipsita; Schatz, Daniel; Reed, Timothy; Krawczyk, Noa.
  • Tofighi B; Department of Population Health, New York University School of Medicine, New York, NY (BT, JM, DW, KF, CSC, IS, DS, NK); Division of General Internal Medicine, Bellevue Hospital Center, New York, NY (BT, JM, DS); Center for Drug Use and HIV Research, New York, NY (BT, JM, NK); NYC Health+Hospitals, New York, NY (DS); Department of Psychiatry, New York University School of Medicine, New York, NY (AD); Department of Psychiatry, Bellevue Hospital Center, New York, NY (DW, KF, AD, CSC, IS, TR).
J Addict Med ; 16(1): e40-e43, 2022.
Article in English | MEDLINE | ID: covidwho-1072432
ABSTRACT

OBJECTIVES:

The purpose of this study was to assess the feasibility and clinical impact of telemedicine-based opioid treatment with buprenorphine-naloxone following the Coronavirus disease 2019 pandemic.

METHODS:

Participants included in this retrospective analysis consisted of adult New York City residents with opioid use disorder eligible for enrollment in the NYC Health+Hospitals Virtual Buprenorphine Clinic between March and May 2020 (n = 78). Follow-up data were comprised of rates of retention in treatment at 2 months, referrals to community treatment, and induction-related events.

RESULTS:

During the initial 9 weeks of clinic operations, the clinic inducted 78 patients on to buprenorphine-naloxone and completed 252 visits. Patient referrals included non-NYC Health + Hospitals (n = 22, 28.2%) and NYC Health + Hospitals healthcare providers (n = 17, 21.8%), homeless shelter staff (n = 13, 16.7%), and the NYC Health + Hospitals jail reentry program in Rikers Island (n = 11, 14.1%). At 8 weeks, 42 patients remained in care (53.8%), 21 were referred to a community treatment program (26.9%), and 15 were lost to follow-up (19.2%). No patients were terminated from care due to disruptive behavior or suspicions of diversion or misuse of Buprenorphine. Adverse clinical outcomes were uncommon and included persistent withdrawal symptoms (n = 8, 4.3%) and one nonfatal opioid overdose (0.5%).

CONCLUSIONS:

Telemedicine-based opioid treatment and unobserved home induction on buprenorphine-naloxone offers a safe and feasible approach to expand the reach of opioid use disorder treatment, primary care, and behavioral health for a highly vulnerable urban population during an unprecedented natural disaster.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Buprenorphine / Telemedicine / COVID-19 / Opioid-Related Disorders Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: J Addict Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Buprenorphine / Telemedicine / COVID-19 / Opioid-Related Disorders Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: J Addict Med Year: 2022 Document Type: Article