Comparing telemedicine to in-person buprenorphine treatment in U.S. veterans with opioid use disorder.
J Subst Abuse Treat
; 133: 108492, 2022 02.
Article
in English
| MEDLINE | ID: covidwho-1253265
ABSTRACT
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 = 2.12, 95% CI1.92-2.35). 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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Veterans
/
Buprenorphine
/
Telemedicine
/
COVID-19
/
Opioid-Related Disorders
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Humans
/
Male
Language:
English
Journal:
J Subst Abuse Treat
Journal subject:
Substance-Related Disorders
Year:
2022
Document Type:
Article
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