The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting

Eibl, Joseph K.; Gauthier, Graham; Pellegrini, David; Daiter, Jeffery; Varenbut, Michael; Hogenbirk, John C.; Marsh, David C.

doi:10.1016/j.drugalcdep.2017.01.048

Cited by 131 publications

(138 citation statements)

References 22 publications

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“…A second cohort study retrospectively analyzed data from an administrative database in Ontario, Canada, to evaluate the effectiveness of telemedicine‐delivered opioid agonist therapy in rural areas . This study found that retention in treatment was superior for patients who received their care through telemedicine visits compared to face‐to‐face visits, 50% versus 39% retention at 1 year, possibly reflecting patients’ continued ability to access services.…”

Section: Discussionmentioning

confidence: 99%

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

et al. 2018

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Background and Objectives The opioid epidemic in the United States has resulted in a public health emergency. Medication‐assisted treatment (MAT) with methadone and buprenorphine are evidence‐based treatments for opioid use disorder. However, numerous barriers hinder access to treatment in rural areas. The use of telemedicine to deliver psychiatric services is demonstrated to be safe and effective; however, limited data exist on the novel application of telemedicine in the delivery of MAT. This report describes the results of a retrospective chart review of 177 patients in a rural drug treatment center that were treated with buprenorphine through telemedicine. Methods This study evaluated a program that began providing buprenorphine treatment to patients at a drug treatment center in rural Maryland via telemedicine in August 2015. A chart review was performed of the first 177 patients who were enrolled in the program. Data were extracted to examine retention in treatment and rates of continued opioid use. Results Retention in treatment was 98% at 1 week, 91% at 1 month, 73% at 2 months, and 57% at 3 months. Of patients still engaged in treatment at 3 months, 86% had opioid‐negative urine toxicology. Discussion and Conclusions Our findings suggest that treatment with buprenorphine can be effectively delivered by telemedicine to patients with opioid use disorders in a rural drug treatment program. Scientific Significance This use of telemedicine is a potential tool to expand medication‐assisted treatment to underserved rural populations. (Am J Addict 2018;XX:1–6)

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Section: Discussionmentioning

confidence: 99%

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

et al. 2018

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“…If patients started on OAT at the end of 2015, they were followed until December 31, 2016. The number of people in OAT is commonly used as a proxy measure for estimating the prevalence of OUD in a population since it is difficult to estimate the true prevalence of patients not seeking treatment [23,24,[32][33][34]. The first episode of OAT was used to identify patients, meaning that there was no previous history of OAT (including methadone or buprenorphine/naloxone) in the year before to the first treatment episode.…”

Section: Study Overviewmentioning

confidence: 99%

“…Opioid Agonist Treatment (OAT) is currently the standard of care and the intervention with the best evidence for long term patient safety, social wellness, and physical health benefits for the treatment of OUD [22]. In many studies, OAT rates have been used to measure the prevalence of OUD in the population [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

A retrospective cohort study evaluating correlates of deep tissue infections among patients enrolled in opioid agonist treatment using administrative data in Ontario, Canada

et al. 2020

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The objective of this study was to evaluate the relationship between individual characteristics and deep tissue infections in patients enrolled in opioid agonist treatment in Ontario, Canada. Methods A retrospective cohort study was conducted on patients in opioid agonist treatment between January 1, 2011, and December 31, 2015 in Ontario, Canada. Patients were identified using data from the Ontario Health Insurance Plan Database, and the Ontario Drug Benefit Plan Database. We identified other study variables including all-cause mortality using data from the Registered Persons Database. Encrypted patient identifiers were used to link across databases. Logistic regression models were used to measure potential correlates of deep tissue infections. Results An increase in the incidence of deep tissue infections was observed between 2011 and 2016 for patients on opioid agonist treatment. Additionally, age, sex, positive HIV diagnosis, and all-cause mortality was correlated with deep tissue infection in our study population. Conclusion The study indicates factors that are associated with deep tissue infections in the opioid use disorder population and can be used to identify opportunities to reduce the incidence of new infections.

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“…Patients with OUD report that the delivery of MAT via telemedicine is an acceptable modality of treatment (Rakita, Giacobbe, & Cavacuiti, 2016), and patients receiving MAT via telemedicine have similar rates of abstinence and retention at treatment at 90 days and 1 year, compared to those receiving MAT inperson (Zheng et al, 2017). In one large study conducted in Canada, patients receiving MAT via telemedicine had higher treatment retention rates at one year, compared to those receiving in-person care, 50% vs. 39% respectively (Eibl et al, 2017). These studies suggest that the delivery of MAT via telemedicine may be an effective alternative and has the potential to expand treatment in rural areas where physician access is limited and OUDs are a critical health problem.…”

Section: Discussionmentioning

confidence: 99%

Assessing the needs of front-line providers in addressing the opioid crisis in South Carolina

Moreland

McCauley

Barth

et al. 2020

Journal of Substance Abuse Treatment

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Opioid use disorder (OUD) has been declared a national crisis, as prevalence of OUD has increased remarkably over the past decade (Jones, 2017). While Medication Assisted Treatment (MAT) is the standard of care for OUDs, several key barriers to implementation have been noted throughout the clinical and research literature (DeFlavio et al., 2015). As a first step toward enhancing implementation and dissemination of MAT across the state of South Carolina, a needs assessment was conducted with key persons from 33 agencies to inform our efforts. Results provided descriptive information regarding medical providers and patients seen within agencies. Of the 33 agencies, 6 agencies (18%) reported having buprenorphine-waivered providers on staff (total of 11 medical providers across the 6 agencies). Agencies reported that they referred a mean of 4.63 patients to other facilities for MAT in the past month. Barriers to providing MAT were identified, with the most significant barrier including the lack of medical staff to prescribe buprenorphine (47%). Overall, the current study reiterates the gap between treatment need and capacity for OUD patients, and highlights factors associated with barriers to MAT adoption in state-funded county drug and alcohol agencies across a southern, predominantly rural state.

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The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting

Abstract: Telemedicine may be an effective alternative to delivering in person OAT, and it has the potential to expand access to care in rural, remote, and urban regions.

Cited by 131 publications

References 22 publications

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine

A retrospective cohort study evaluating correlates of deep tissue infections among patients enrolled in opioid agonist treatment using administrative data in Ontario, Canada

Assessing the needs of front-line providers in addressing the opioid crisis in South Carolina

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