Telemedicine in the treatment of addictions

Caballería, Elsa; López‐Pelayo, Hugo; Matrai, Silvia; Gual, Antoni

doi:10.1097/yco.0000000000000795

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…Telemedicine may be particularly suitable for rural regions. In line with our ndings, vulnerable populations need attention [23], as lack of digital literacy, lack of equipment or lack of privacy may be a barrier for some patients [27,31]. Thus, there is an urgent need to study what treatment modalities (remote vs. in-person) work for whom.…”

Section: Discussionmentioning

confidence: 61%

“…Utilization of telemedicine accelerated during the COVID-19 pandemic for many health conditions, including substance use disorders [23,24]. For patients with OUD, telemedicine may improve access to treatment [25], and a recent US cohort study found that its use was associated with improved OAT retention and lower odds of overdose in a during vs. pre-COVID- 19 comparison [26].…”

Section: Discussionmentioning

confidence: 99%

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Flexible delivery of opioid agonist treatment during COVID-19 in Norway: A cross-sectional survey of provider experiences

McDonald

Bech

Clausen

2023

Preprint

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Background and Aims: For patients receiving daily opioid agonist treatment (OAT) for opioid dependence, several countries relaxed treatment guidelines at the beginning of the COVID-19 pandemic. This involved longer take-home intervals for methadone and buprenorphine doses as well as a reduction in supervised dosing and drug screening. To date, little is known about the medium or long-term experience of such OAT deregulation. Therefore, we conducted a survey to explore how OAT providers perceived greater flexibility in OAT service delivery at the end of the second year of the pandemic. Design: Nationwide cross-sectional study. Setting: OAT units in 19 publicly funded hospital trusts in Norway. Participants: Twenty-three (of whom 14 female; 61%) managers or lead physicians of OAT units. Measurements: A 29-item online questionnaire comprising closed-format and open-ended questions covering: treatment provider experiences and changes in OAT service delivery during the past 12 months (January to December 2021). Findings: In 2021, most OAT units (91.3%, n = 21) still practiced some adjusted approaches as established in the beginning of the pandemic. The most common adaptions were special protocols for COVID-19 cases (95.7%, n = 22), increased use of telephone- (91.3%, n= 21) and video consultations (87.0%, n= 20), and longer take-home intervals for OAT medications (52.2%, n = 12). The use of depot buprenorphine also increased substantially during the pandemic. According to the providers, most patients handled flexible treatment provision well. In individual cases, patients’ substance use was identified as key factor necessitating a reintroduction of supervised dosing and drug screening. Collaboration with general practitioners and municipal health and social services was generally perceived as crucial for successful treatment delivery. Conclusions: Overall, the Norwegian OAT system proved resilient in the second year of the COVID-19 pandemic, as its healthcare workforce embraced innovation in technology (telemedicine) and drug development (depot buprenorphine). According to our nationally representative sample of OAT providers, most patients were compliant with longer take-home doses of methadone and buprenorphine. Our findings suggest that telemedicine can be useful as adjunct to face-to-face treatment and provide greater flexibility for patients.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Flexible delivery of opioid agonist treatment during COVID-19 in Norway: A cross-sectional survey of provider experiences

McDonald

Bech

Clausen

2023

Preprint

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“…Remote addiction treatment and support services can be conven iently provided through telemedicine platforms and mobile health apps. Individuals with addiction can receive medication-assisted treatment, peer support networks, and counsel ling via secure communication channels and virtual consultations [47]. Predictive analytics is another tool that health informatics uses to identify people who may return to use or develop drug-use disorders.…”

Section: Applications Of Health Informatics In Drug Addiction Managementmentioning

confidence: 99%

Exploring Health Informatics in the Battle against Drug Addiction: Digital Solutions for the Rising Concern

Shimu,

Patil,

Dadzie

et al. 2024

JPM

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Drug addiction is a rising concern globally that has deeply attracted the attention of the healthcare sector. The United States is not an exception, and the drug addiction crisis there is even more serious, with 10% of adults having faced substance use disorder, while around 75% of this number has been reported as not having received any treatment. Surprisingly, there are annually over 70,000 deaths reported as being due to drug overdose. Researchers are continually searching for solutions, as the current strategies have been ineffective. Health informatics platforms like electronic health records, telemedicine, and the clinical decision support system have great potential in tracking the healthcare data of patients on an individual basis and provide precise medical support in a private space. Such technologies have been found to be useful in identifying the risk factors of drug addiction among people and mitigating them. Moreover, the platforms can be used to check prescriptions of addictive drugs such as opioids and caution healthcare providers. Programs such as the Prescription Drug Monitoring Program (PDMP) and the Drug and Alcohol Services Information Systems (DASIS) are already in action in the US, but the situation demands more in-depth studies in order to mitigate substance use disorders. Artificial intelligence (AI), when combined with health informatics, can aid in the analysis of large amounts of patient data and aid in classifying nature of addiction to assist in the provision of personalized care.

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“…Moreover, if substance use service delivery will become more digitally dependent in the future, it is necessary to anticipate and reconsider the impact of socioeconomic disadvantage and its impact on service access at regional, national, and global levels [ 39 ]. The ongoing digitalization of the substance use sector has thus created a range of specific challenges [ 20 - 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Approaches in the field of substance use include prevention, early intervention, treatment, harm reduction, and recovery. A wide range of emerging digital tools influence these approaches in the domains of research, service provision, and policy making, including apps [16], chatbots [17], algorithms [18], dashboards [19], new service modalities [20][21][22][23], and use of digital tools for substance use [24][25][26][27]. The digitalization of this field brings with it the promise of extended access to services and more efficient distribution of limited expertise by means of telemedicine [28], better public health intelligence concerning substance use trends through data linkage studies [29], predictive models of substance use-related risks through artificial intelligence algorithms [30], improved provision of harm reduction interventions [31,32], and more effective prevention and early interventions for hard-to-reach populations [33,34].…”

Section: Introductionmentioning

confidence: 99%

Optimizing Digital Tools for the Field of Substance Use and Substance Use Disorders: Backcasting Exercise

Scheibein¹,

Caballería²,

Taher³

et al. 2023

JMIR Hum Factors

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Background Substance use trends are complex; they often rapidly evolve and necessitate an intersectional approach in research, service, and policy making. Current and emerging digital tools related to substance use are promising but also create a range of challenges and opportunities. Objective This paper reports on a backcasting exercise aimed at the development of a roadmap that identifies values, challenges, facilitators, and milestones to achieve optimal use of digital tools in the substance use field by 2030. Methods A backcasting exercise method was adopted, wherein the core elements are identifying key values, challenges, facilitators, milestones, cornerstones and a current, desired, and future scenario. A structured approach was used by means of (1) an Open Science Framework page as a web-based collaborative working space and (2) key stakeholders’ collaborative engagement during the 2022 Lisbon Addiction Conference. Results The identified key values were digital rights, evidence-based tools, user-friendliness, accessibility and availability, and person-centeredness. The key challenges identified were ethical funding, regulations, commercialization, best practice models, digital literacy, and access or reach. The key facilitators identified were scientific research, interoperable infrastructure and a culture of innovation, expertise, ethical funding, user-friendly designs, and digital rights and regulations. A range of milestones were identified. The overarching identified cornerstones consisted of creating ethical frameworks, increasing access to digital tools, and continuous trend analysis. Conclusions The use of digital tools in the field of substance use is linked to a range of risks and opportunities that need to be managed. The current trajectories of the use of such tools are heavily influenced by large multinational for-profit companies with relatively little involvement of key stakeholders such as people who use drugs, service providers, and researchers. The current funding models are problematic and lack the necessary flexibility associated with best practice business approaches such as lean and agile principles to design and execute customer discovery methods. Accessibility and availability, digital rights, user-friendly design, and person-focused approaches should be at the forefront in the further development of digital tools. Global legislative and technical infrastructures by means of a global action plan and strategy are necessary and should include ethical frameworks, accessibility of digital tools for substance use, and continuous trend analysis as cornerstones.

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Telemedicine in the treatment of addictions

Cited by 7 publications

References 30 publications

Flexible delivery of opioid agonist treatment during COVID-19 in Norway: A cross-sectional survey of provider experiences

Flexible delivery of opioid agonist treatment during COVID-19 in Norway: A cross-sectional survey of provider experiences

Exploring Health Informatics in the Battle against Drug Addiction: Digital Solutions for the Rising Concern

Optimizing Digital Tools for the Field of Substance Use and Substance Use Disorders: Backcasting Exercise

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