Patient Retention in a Substance Use Disorder Telemedicine Clinic.

OBJECTIVES: Although research has continued to show that substance use disorders (SUDs) can be treated effectively with evidence-based treatment, there continues to be gaps in access, and utilization remains low. Alternative SUD treatment methods, including telemedicine, are increasingly being explored to reach patients where traditional in-person treatment approaches are inaccessible. This cross-sectional study aimed to explore SUD treatment retention, specifically comparing telemedicine-delivered opioid use disorder (OUD) treatment with a traditional in-person treatment delivery approach. METHODS: Patients at Cahaba Medical Care, an FQHC in Birmingham, AL with a diagnosis of OUD and undergoing buprenorphine/naloxone or buprenorphine treatment were categorized into two groups: treatment and control. The dependent variable, retention to SUD treatment, was assessed at four different time periods over 12 months to determine patient SUD consultation appointment attendance. Multiple linear regression was used to examine the relationship between SUD treatment retention and delivery mode. Correlations were obtained to assess associations between frequency of urine drug screens performed and SUD treatment retention. RESULTS: As the number of the urine drug screens patients received increased by 1, the number of SUD treatment program consultations patients attended increased by 0.69 (P < 0.001). There was no significant difference in SUD treatment retention between traditional in-person and telemedicine delivered approaches, however. CONCLUSIONS: The findings of this study suggest that a telemedicine-delivered treatment program equals retention effectiveness when compared with in-person delivery. This suggests that leveraging telemedicine to treat patients with SUD could be an effective alternative for those unable to access treatment or who are less likely to attend or complete traditional in-person treatment sessions.

Evaluation of a COVID-19 Risk Tool.

Some of the most vexing issues with the COVID-19 pandemic were the inability of schools and work areas to track symptoms. Technology solutions to mitigate repercussions of the COVID-19 pandemic include tools that provide guidelines and interfaces to influence behavior, reduce exposure to the disease, and enable policy-driven avenues to return to a sense of normalcy (e.g., school and work). This presentation presents the implementation and early evaluation of a return-to-work COVID-19 symptom and risk assessment tool.

Substance Use Telemedicine Retention and Outcomes.

Evidence-based SUD treatments are available, yet utilization remains low demonstrating the need to utilize alternative treatment delivery methods. We assess the effectiveness of an SUD treatment program delivered via telemedicine and in-person mode over 12 months. 40% of the intervention group remained engaged and 46% remained opioid free.

Predictors of COVID-19 From a Statewide Digital Symptom and Risk Assessment Tool: Cross-Sectional Study.

BACKGROUND: Some of the most vexing issues with the COVID-19 pandemic were the inability of facilities and events, such as schools and work areas, to track symptoms to mitigate the spread of the disease. To combat these challenges, many turned to the implementation of technology. Technology solutions to mitigate repercussions of the COVID-19 pandemic include tools that provide guidelines and interfaces to influence behavior, reduce exposure to the disease, and enable policy-driven avenues to return to a sense of normalcy. This paper presents the implementation and early evaluation of a return-to-work COVID-19 symptom and risk assessment tool. The system was implemented across 34 institutions of health and education in Alabama, including more than 174,000 users with over 4 million total uses and more than 86,000 reports of exposure risk between July 2020 and April 2021. OBJECTIVE: This study aimed to explore the usage of technology, specifically a COVID-19 symptom and risk assessment tool, to mitigate exposure to COVID-19 within public spaces. More specifically, the objective was to assess the relationship between user-reported symptoms and exposure via a mobile health app, with confirmed COVID-19 cases reported by the Alabama Department of Public Health (ADPH). METHODS: This cross-sectional study evaluated the relationship between confirmed COVID-19 cases and user-reported COVID-19 symptoms and exposure reported through the Healthcheck web-based mobile application. A dependent variable for confirmed COVID-19 cases in Alabama was obtained from ADPH. Independent variables (ie, health symptoms and exposure) were collected through Healthcheck survey data and included measures assessing COVID-19-related risk levels and symptoms. Multiple linear regression was used to examine the relationship between ADPH-confirmed diagnosis of COVID-19 and self-reported health symptoms and exposure via Healthcheck that were analyzed across the state population but not connected at the individual patient level. RESULTS: Regression analysis showed that the self-reported information collected by Healthcheck significantly affects the number of COVID-19-confirmed cases. The results demonstrate that the average number of confirmed COVID-19 cases increased by 5 (high risk: ß=5.10; P=.001), decreased by 24 (sore throat: ß=-24.03; P=.001), and increased by 21 (nausea or vomiting: ß=21.67; P=.02) per day for every additional self-report of symptoms by Healthcheck survey respondents. Congestion or runny nose was the most frequently reported symptom. Sore throat, low risk, high risk, nausea, or vomiting were all statistically significant factors. CONCLUSIONS: The use of technology allowed organizations to remotely track a population as it is related to COVID-19. Healthcheck was a platform that aided in symptom tracking, risk assessment, and evaluation of status for admitting individuals into public spaces for people in the Alabama area. The confirmed relationship between symptom and exposure self-reporting using an app and population-wide confirmed cases suggests that further investigation is needed to determine the opportunity for such apps to mitigate disease spread at a community and individual level.

Increased Hepatitis C Virus (HCV) Detection in Women of Childbearing Age and Potential Risk for Vertical Transmission - United States and Kentucky, 2011-2014.

Hepatitis C virus (HCV) infection is a leading cause of liver-related morbidity and mortality (1). Transmission of HCV is primarily via parenteral blood exposure, and HCV can be transmitted vertically from mother to child. Vertical transmission occurs in 5.8% (95% confidence interval = 4.2%-7.8%) of infants born to women who are infected only with HCV and in up to twice as many infants born to women who are also infected with human immunodeficiency virus (HIV) (2) or who have high HCV viral loads (3,4); there is currently no recommended intervention to prevent transmission of infection from mother to child (3). Increased reported incidence of HCV infection among persons aged ≤30 years (5,6) with similar increases among women and men in this age group (6), raises concern about increases in the number of pregnant women with HCV infection, and in the number of infants who could be exposed to HCV at birth. Data from one large commercial laboratory and birth certificate data were used to investigate trends in HCV detection among women of childbearing age,* HCV testing among children aged ≤2 years, and the proportions of infants born to HCV-infected women nationally and in Kentucky, the state with the highest incidence of acute HCV infection during 2011-2014 (6). During 2011-2014, commercial laboratory data indicated that national rates of HCV detection (antibody or RNA positivity(†)) among women of childbearing age increased 22%, and HCV testing (antibody or RNA) among children aged ≤2 years increased 14%; birth certificate data indicated that the proportion of infants born to HCV-infected mothers increased 68%, from 0.19% to 0.32%. During the same time in Kentucky, the HCV detection rate among women of childbearing age increased >200%, HCV testing among children aged ≤2 years increased 151%, and the proportion of infants born to HCV-infected women increased 124%, from 0.71% to 1.59%. Increases in the rate of HCV detection among women of childbearing age suggest a potential risk for vertical transmission of HCV. These findings highlight the importance of following current CDC recommendations to identify, counsel, and test persons at risk for HCV infection (1,7), including pregnant women, as well as consider developing public health policies for routine HCV testing of pregnant women, and expanding current policies for testing and monitoring children born to HCV-infected women. Expansion of HCV reporting and surveillance requirements will enhance case identification and prevention strategies.