Addiction Treatment and Telehealth: Review of Efficacy and Provider Insights During the COVID-19 Pandemic

Mark, Tami L.; Treiman, Katherine; Padwa, Howard; Henretty, Kristen; Tzeng, Janice; Gilbert, Marylou

doi:10.1176/appi.ps.202100088

Cited by 78 publications

(81 citation statements)

References 18 publications

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“…Historically, peer-based connections and the therapeutic milieu have been integral parts of addiction treatment. Concern has been expressed by the addiction treatment community regarding the shift to virtual services and its impact on group engagement and patient-centered outcomes [ 34 ]. These preliminary results demonstrate the feasibility of offering services virtually.…”

Section: Discussionmentioning

confidence: 99%

Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices

Gliske¹,

Welsh²,

Braughton³

et al. 2022

JMIR Ment Health

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Background The onset of the COVID-19 pandemic necessitated the rapid transition of many types of substance use disorder (SUD) treatments to telehealth formats, despite limited information about what makes treatment effective in this novel format. Objective This study aims to examine the feasibility and effectiveness of virtual intensive outpatient programming (IOP) treatment for SUD in the context of a global pandemic, while considering the unique challenges posed to data collection during an unprecedented public health crisis. Methods The study is based on a longitudinal study with a baseline sample of 3642 patients who enrolled in intensive outpatient addiction treatment (in-person, hybrid, or virtual care) from January 2020 to March 2021 at a large substance use treatment center in the United States. The analytical sample consisted of patients who completed the 3-month postdischarge outcome survey as part of routine outcome monitoring (n=1060, 29.1% response rate). Results No significant differences were detected by delivery format in continuous abstinence (χ22=0.4, P=.81), overall quality of life (F2,826=2.06, P=.13), financial well-being (F2,767=2.30, P=.10), psychological well-being (F2,918=0.72, P=.49), and confidence in one’s ability to stay sober (F2,941=0.21, P=.81). Individuals in hybrid programming were more likely to report a higher level of general health than those in virtual IOP (F2,917=4.19, P=.01). Conclusions Virtual outpatient care for the treatment of SUD is a feasible alternative to in-person-only programming, leading to similar self-reported outcomes at 3 months postdischarge. Given the many obstacles presented throughout data collection during a pandemic, further research is needed to better understand under what conditions telehealth is an acceptable alternative to in-person care.

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Section: Discussionmentioning

confidence: 99%

Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices

Gliske¹,

Welsh²,

Braughton³

et al. 2022

JMIR Ment Health

View full text Add to dashboard Cite

show abstract

“…Advances in mental health delivery, including virtual therapy sessions and support groups, along with on-line education and coaching, can enhance knowledge while building resilience [ 28 ] Virtual sessions can also provide grief and bereavement support for those experiencing loss of a loved one through cancer, opioid overdose or COVID-19. Telehealth has also been successfully employed to support sobriety through SUD treatment [ 30 , 31 ].…”

Section: Solutionsmentioning

confidence: 99%

Cancer pain during an epidemic and a pandemic

Paice

2022

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review As our global population ages, cancer has become more prevalent. Thankfully, oncologic treatments are highly effective, leading to significantly improved rates of long-term survival. However, many of these therapies are associated with persistent pain syndromes. Clinicians caring for people with cancer must understand how the influence of the current epidemic of opioid misuse and the coronavirus disease 2019 (COVID-19) pandemic have complicated cancer pain management. Creative solutions can emerge from this knowledge. Recent findings Persistent pain due to cancer and its treatment can be managed through multimodal care, although efforts to mitigate the opioid misuse epidemic have created challenges in access to appropriate treatment. Isolation measures associated with the COVID-19 pandemic have limited access to nonpharmacologic therapies, such as physical therapy, and have exacerbated mental health disorders, including anxiety and depression. Summary Cancer pain treatment requires more nuanced assessment and treatment decisions as patients live longer. Societal factors multiply existing challenges to cancer pain relief. Research is needed to support safe and effective therapies.

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“…The data do not provide an exact reason for these restricted hours, but rural vendors did have smaller budgets that prevented hiring peers to provide more extensive coverage and scheduling peer shifts during normal business hours was likely to attract more potential hires in rural areas where the applicant pool was likely smaller. One potential solution to low patient volume and incompatible staffing coverage would be to partner with an external peer telehealth hub that operates 24 h a day, as use of telehealth for substance use disorder and specialist services in the ED is becoming more common [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Identifying unique barriers to implementing rural emergency department-based peer services for opioid use disorder through qualitative comparison with urban sites

Watson

Staton

2022

Addict Sci Clin Pract

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Background In an effort to address the current opioid epidemic, a number of hospitals across the United States have implemented emergency department-based interventions for engaging patients presenting with opioid use disorder. The current study seeks to address gaps in knowledge regarding implementation of a sub-type of such interventions, emergency department-based peer support services, in rural areas by comparing implementation of rural and urban programs that participated in Indiana’s Recovery Coach and Peer Support Initiative (RCPSI). Methods We conducted a secondary analysis of qualitative semi-structured implementation interviews collected as part of an evaluation of 10 programs (4 rural and 6 urban) participating in the RCPSI. We conducted interviews with representatives from each program at 3 time points over the course of the first year of implementation. Our deductive coding process was guided by the Consolidated Framework for Implementation Research (CFIR) and an external context taxonomy. Results We identified key differences for rural programs corresponding to each of the 5 primary constructs in the coding scheme. (1) Intervention characteristics: rural sites questioned intervention fit with their context, required more adaptations, and encountered unexpected costs. (2) External context: rural sites were not appropriately staffed to meet patient needs, encountered logistical and legal barriers regarding patient privacy, and had limited patient transportation options. (3) Inner setting: rural sites lacked strong mechanisms for internal communication and difficulties integrating with pre-existing culture and climate. (4) Characteristics of individuals: some rural providers resisted working with peers due to pre-existing attitudes and beliefs. (5) Implementation process: rural sites spent more time identifying external partners and abandoned more components of their initial implementation plans. Conclusions Findings demonstrate how rural programs faced greater challenges implementing emergency department-based peer services over time. These challenges required flexible adaptations to originally intended plans. Rural programs likely require flexibility to adapt interventions that were developed in urban settings to ensure success considering local contextual constraints that were identified by our analysis.

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Addiction Treatment and Telehealth: Review of Efficacy and Provider Insights During the COVID-19 Pandemic

Cited by 78 publications

References 18 publications

Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices

Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices

Cancer pain during an epidemic and a pandemic

Identifying unique barriers to implementing rural emergency department-based peer services for opioid use disorder through qualitative comparison with urban sites

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