Telehealth-delivered Psychotherapy for the Treatment of Alcohol Use Disorder: Patient Perspectives in the Age of COVID-19.

OBJECTIVES: The COVID-19 pandemic precipitated increases in alcohol use and ushered in virtually delivered health care, creating an opportunity to examine the impacts of telehealth on alcohol use disorder (AUD) treatment. To understand these impacts, we explored perspectives on telehealth-delivered psychotherapy among individuals with AUD. METHODS: This was a qualitative study using semi-structured interviews. Participants (N = 31) were patients with AUD who had received telehealth-delivered AUD psychotherapy in the last 2 years (n = 11) or had never experienced AUD psychotherapy (n = 20), recruited from two large academically-affiliated health care systems in Michigan between July and August 2020. Participants were asked about perceived barriers and facilitators to AUD psychotherapy, benefits and drawbacks of telehealth-delivered AUD psychotherapy, and changes needed to improve psychotherapy delivery. Interviews were transcribed, coded, and analyzed iteratively using thematic analysis. RESULTS: Participants identified factors relating to perceptions of and experience with telehealth-delivered AUD psychotherapy. Findings reflected four major themes: treatment accessibility, treatment flexibility, treatment engagement, and stigma. Perceptions about telehealth's impact on treatment accessibility varied widely and included benefits (e.g., eliminating transportation challenges) and barriers (e.g., technology costs). Treatment flexibility and treatment engagement factors included the ability to use phone and video and perceptions of receiving care via telehealth, respectively. Telehealth impacts on treatment stigma were also a key theme. CONCLUSIONS: Overall, perceptions of telehealth treatment for AUD varied. Participants expressed the importance of options, flexibility, and collaborating on decisions with providers to determine treatment modality. Future research should explore who benefits most from telehealth and avenues to enhance implementation.

Heart failure patients' experiences of a self-management peer support program: a qualitative study.

OBJECTIVES: Explore the experiences of patients with heart failure in a self-management support program to inform the development of future interventions that support and motivate patients to engage in self-management. BACKGROUND: Peer-support programs have led to improved outcomes among patients with other chronic conditions and may result in similar improvements for heart failure patients. Yet, among patients recently hospitalized for heart failure, over half had no or minimal engagement with a reciprocal peer support program. METHODS: Qualitative semi-structured interviews with a purposive sample of 28 patients (mean age 72; 71% Female; 21% African-American; 75% Caucasian) with different levels and types of engagement in a heart failure self-management support program. RESULTS: Key themes that emerged included the importance of heart failure specific-social support, sharing information, comparing self to others, depression, and functional status. CONCLUSIONS: Useful services for heart failure patients provide comfort, restore confidence, and offer practical solutions.