Your browser doesn't support javascript.
Understanding opportunities and challenges with telemedicine-delivered buprenorphine during the COVID-19 pandemic.
Mattocks, Kristin M; Moore, David T; Wischik, Dora Lendvai; Lazar, Christina M; Rosen, Marc I.
  • Mattocks KM; VA Central Western Massachusetts Healthcare System, Leeds, MA, United States of America; University of Massachusetts Medical School, Worcester, MA, United States of America. Electronic address: Kristin.Mattocks@va.gov.
  • Moore DT; Yale University School of Medicine, New Haven, CT, United States of America; VA Connecticut Healthcare System, West Haven, CT, United States of America.
  • Wischik DL; VA Connecticut Healthcare System, West Haven, CT, United States of America; Yale University School of Nursing, New Haven, CT, United States of America.
  • Lazar CM; Yale University School of Medicine, New Haven, CT, United States of America; VA Connecticut Healthcare System, West Haven, CT, United States of America.
  • Rosen MI; Yale University School of Medicine, New Haven, CT, United States of America; VA Connecticut Healthcare System, West Haven, CT, United States of America.
J Subst Abuse Treat ; 139: 108777, 2022 08.
Article in English | MEDLINE | ID: covidwho-1889645
ABSTRACT

INTRODUCTION:

Opioid use disorder (OUD) is a debilitating illness that remains a serious public health issue in the United States. Use of telemedicine to deliver medications for the treatment of OUD (MOUD) was limited until the confluence of the COVID-19 and opioid addiction epidemics in spring 2020. Starting in spring 2020, the Department of Veterans Health Affairs (VHA) transitioned from in-person to mostly telemedicine-delivered OUD care to reduce COVID-19 transmission among veterans and providers. To gain a nuanced understanding of provider perspectives on MOUD care delivery using telemedicine, we conducted semi-structured interviews with VHA providers who were using telehealth to deliver MOUD care.

METHODS:

We conducted semi-structed Zoom interviews with VA clinicians at nine VA Medical Centers (VAMCs) in eight states. Potential study participants were identified as providers who were involved in referrals and provision of buprenorphine treatment for chronic pain and opioid addiction. Audio-recordings of all interviews were transcribed and entered into Atlas. Ti qualitative analysis software. The study team analyzed the transcripts for major themes related to tele-prescribing practices for buprenorphine.

RESULTS:

Twenty-three VA providers participated in the study, representing 32% of all providers invited to participate in the study. The research team identified the following four themes (1) COVID-19 spurred a seismic shift in OUD treatment; (2) Video calls provided a rare window into veterans' lives; (3) Providers experienced numerous challenges to virtual visits; and (4) Providers wrestled with paternalism and trust.

CONCLUSIONS:

The pandemic accelerated the movement toward harm reduction approaches. Prior to the pandemic, stringent requirements existed for patients receiving MOUD care. Providers in this study reflected on the need for these requirements (e.g., in-person visits, toxicology screens) and how reducing this monitoring implied more trust in patients' autonomous decisions. Providers' observation that videoconferencing offered them a window into patients' lives may offer some ways to improve rapport, and research should explore how best to incorporate the additional information conveyed in virtual visits.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Buprenorphine / Telemedicine / COVID-19 / Opioid-Related Disorders Type of study: Observational study / Prognostic study / Qualitative research Limits: Humans Country/Region as subject: North America Language: English Journal: J Subst Abuse Treat Journal subject: Substance-Related Disorders Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Buprenorphine / Telemedicine / COVID-19 / Opioid-Related Disorders Type of study: Observational study / Prognostic study / Qualitative research Limits: Humans Country/Region as subject: North America Language: English Journal: J Subst Abuse Treat Journal subject: Substance-Related Disorders Year: 2022 Document Type: Article