Patient Experiences with the Transition to Telephone Counseling during the COVID-19 Pandemic

Kang, Aram; Walton, Mary; Hoadley, Ariel; DelaCuesta, Courtney; Hurley, Linda; Martin, Rosemarie A.

doi:10.3390/healthcare9060663

Cited by 7 publications

(8 citation statements)

References 13 publications

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“…To our knowledge, this study is among a very few to report direct patient experience with policy changes in MOUD access during COVID. A telehealth satisfaction survey was conducted in one Rhode Island provider setting [ 35 ], a survey study of North Carolina patients in three methadone clinics was reported [ 36 ], and a very small, non-peer reviewed study in one San Francisco methadone clinic with 10 providers and 20 patients reported views about methadone take-home dosing [ 37 ]. The North Carolina study found that take-home doses increased from pre-COVID periods to the time of the study (summer 2020) from 56–82% to 78–100%, though notably, the clinic-level percent of patients receiving a week or longer (>6 days) ranged from 11–56%.…”

Section: Discussionmentioning

confidence: 99%

Nothing really changed: Arizona patient experience of methadone and buprenorphine access during COVID

Meyerson

Bentele²,

Russell³

et al. 2022

PLoS ONE

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Objective To understand patient experience of federal regulatory changes governing methadone and buprenorphine (MOUD) access in Arizona during the COVID-19 pandemic. Methods This community-based participatory and action research study involved one-hour, audio-recorded field interviews conducted with 131 people who used methadone and/or buprenorphine to address opioid use disorder at some point during COVID (January 1, 2020- March 31, 2021) in Arizona. Transcribed data were analyzed using a priori codes focused on federally recommended flexibilities governing MOUD access. Data were quantitated to investigate associations with COVID risk and services access. Results Telehealth was reported by 71.0% of participants, but the majority were required to come to the clinic to attend video appointments with an offsite provider. Risk for severe COVID outcomes was reported by 40.5% of the sample. Thirty-eight percent of the sample and 39.7% of methadone patients were required to be at the clinic daily to get medication and 47.6% were at high risk for COVID severe outcomes. About half (54.2%) of methadone patients indicated that some form of multi-day take home dosing was offered at their clinic, and 45.8% were offered an extra day or two of multi-day doses; but no participants received the federally allowed 14- or 28-day methadone take-home doses for unstable and stable patients respectively. All participants expressed that daily clinic visits interrupted their work and home lives and desired more take-home dosing and home delivery options. Conclusions MOUD patients in Arizona were not offered many of the federally allowed flexibilities for access that were designed to reduce their need to be at the clinic. To understand the impact of these recommended treatment changes in Arizona, and other states where they were not well implemented, federal and state regulators must mandate these changes and support MOUD providers to implement them.

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Section: Discussionmentioning

confidence: 99%

Nothing really changed: Arizona patient experience of methadone and buprenorphine access during COVID

Meyerson

Bentele²,

Russell³

et al. 2022

PLoS ONE

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“…Given the range of COVID-related SUD policy changes that were implemented, understanding the experiences of people involved with those changes will be critical to discussions about any permanent policy changes. To date, few studies have described provider or patient perspectives regarding the impacts of COVID-19 on OUD treatment 25-29 . The present study expands prior work in other states by adding findings from within a sample of NC's Medicaid system, including perspectives from the state, LME/MCOs, providers, and beneficiaries.…”

Section: Discussionmentioning

confidence: 78%

“…To date, few studies have described provider or patient perspectives regarding the impacts of COVID-19 on OUD treatment. [25][26][27][28][29] The present study expands prior work in other states by adding findings from within a sample of NC's Medicaid system, including perspectives from the state, LME/MCOs, providers, and beneficiaries. Consistent with several prior studies [25][26][27][28] and in contrast to another, 29 these changes were generally well received by providers and patients in this study.…”

Section: Discussionmentioning

confidence: 81%

North Carolina Medicaid System Perspectives on Substance Use Disorder Treatment Policy Changes during the COVID-19 Pandemic

Hughes,

Easterly,

Thomas

et al. 2024

J Addict Med

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Objective This study aimed to describe perspectives from stakeholders involved in the Medicaid system in North Carolina regarding substance use disorder (SUD) treatment policy changes during the coronavirus disease 2019 pandemic. Methods We conducted semistructured interviews in early 2022 with state agency representatives, Medicaid managed care organizations, and Medicaid providers (n = 22) as well as 3 focus groups of Medicaid beneficiaries with SUD (n = 14). Interviews and focus groups focused on 4 topics: policies, meeting needs during COVID, demand for SUD services, and staffing. Results Overall, policy changes, such as telehealth and take-home methadone, were considered beneficial, with participants displaying substantial support for both policies. Shifting demand for services, staffing shortages, and technology barriers presented significant challenges. Innovative benefits and services were used to adapt to these challenges, including the provision of digital devices and data plans to improve access to telehealth. Conclusions Perspectives from Medicaid stakeholders, including state organizations to beneficiaries, support the continuation of SUD policy changes that occurred. Staffing shortages remain a substantial barrier. Based on the participants' positive responses to the SUD policy changes made during the coronavirus disease 2019 pandemic, such as take-home methadone and telehealth initiation of buprenorphine, these changes should be continued. Additional steps are needed to ensure payment parity for telehealth services.

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“…Sixteen in‐depth semi‐structured interviews with a purposeful sample of PPP staff across departments were conducted by our team, which has significant qualitative research experience (Bass et al, 2011 , 2015 ; Gordon et al, 2021 ; Kang et al, 2021 ; Martin et al, 2021 ). Semi‐structured interviews guided conversation and allowed the flexibility to hone discussion towards staff members' roles, experiences and perceptions (Saks & Allsop, 2021 ).…”

Section: Methodsmentioning

confidence: 99%

“We figured it out as we went along”: Staff perspectives of COVID‐19 response efforts at a large North American syringe services programme

Kelly

Pilla

Otor

et al. 2022

Health Social Care Comm

Self Cite

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Syringe services programmes face operational challenges to provide life‐sustaining services to people who use substances and those who have substance use disorders. COVID‐19 has disrupted operations at these programmes and is a threat to people with substance use disorder because of severe poverty, de‐prioritisation of COVID‐19 safety and high prevalence of comorbidities. This phenomenological qualitative study describes 16 in‐depth interviews with staff of one of the largest syringe services programme in North America—Prevention Point Philadelphia, located in the Kensington neighbourhood of Philadelphia, Pennsylvania. Interviews were conducted from December 2020 to February 2021, audio‐recorded, transcribed and coded to develop a thematic framework. Participants were mostly white (71.4%) and female (68.8%) with a median age of 31.5. Three main and four sub‐themes related to the impact of COVID‐19 on the syringe services programme were identified: (1) COVID‐19 altered services provision (sub‐theme: select service changes should be retained); (2) unclear or absent COVID‐19 response guidance which compromised mitigation (sub‐themes: COVID‐19 messaging was difficult to translate to practice, learn‐as‐we‐go); and (3) staff and clients experienced elevated mental anguish during the pandemic (sub‐theme: already limited resources were further strained). COVID‐19 presented complex challenges to an organisation normally strained in pre‐pandemic times. A staff culture of resourcefulness and resiliency aided the syringe services programme to balance client needs and staff safety. However, staff experienced a serious psychological impact, largely attributable to being unable to find reprieve from the stressors of COVID‐19 and the difficulties associated with navigating and acting‐on contradictory public health messaging. Staff also shared a belief that the relaxing of some pre‐pandemic barriers allowed staff to link clients more readily with services. Syringe services programmes should embrace the potential for lasting changes to health services delivery brought about by wide‐scale changes in service provisions because of COVID‐19.

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Patient Experiences with the Transition to Telephone Counseling during the COVID-19 Pandemic

Cited by 7 publications

References 13 publications

Nothing really changed: Arizona patient experience of methadone and buprenorphine access during COVID

Nothing really changed: Arizona patient experience of methadone and buprenorphine access during COVID

North Carolina Medicaid System Perspectives on Substance Use Disorder Treatment Policy Changes during the COVID-19 Pandemic

“We figured it out as we went along”: Staff perspectives of COVID‐19 response efforts at a large North American syringe services programme

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