Use of Telehealth in Substance Use Disorder Services During and After COVID-19: Online Survey Study (Preprint)

Abstract

BACKGROUND COVID-19 social distancing guidelines caused a rapid transition to telephone and video technologies for the delivery of substance use disorder (SUD) treatment. The study examined: a) adoption of these technologies across the SUD service continuum; b) acceptance of these technologies by service providers; and c) intention of providers to use these technologies following the pandemic. An additional analysis used the validated Technology Acceptance Model (TAM) to test the rigor of the intent to use the technology post-pandemic. OBJECTIVE Specific hypotheses were that over 50% of organizations would use telephone and video technologies, that organizations would report statistically significant odds of increasing their use of technology after the COVID-19 pandemic, and that perceived usefulness of telephone and video technologies would mediate the effect of ease of use on intention to use. METHODS An on-line survey distributed between May and August, 2020 measured current use of telephone and video services, assessed perceived organizational readiness to use these services, and gauged intent to use telephone and video applications post-COVID-19. Seven of the 10 Regional Addiction Technology Transfer Centers (ATTCs), representing 43 states, distributed the survey. The unit of analysis was the organization. RESULTS Four hundred and fifty-seven organizations responded. Overall, there was widespread use of technology; greater than 70% of organizations reported using telephone or video for most services. For all but two services (residential and buprenorphine services by telephone), organizations reported significantly greater odds (mean OR = 3.79; range from 1.87 to 6.98) of intending to use technology to deliver services post COVID-19. Clinical users regarded video more favorably than telephone for all but two services. Readiness for telephone and video use was high across numerous factors, though telephone services were viewed as being more accessible. Consistent with the TAM, perceived usefulness and ease of use influenced intention to use both telephone and video technologies. CONCLUSIONS The overall perceived ease of use and usefulness of telephone and video-based services provide a promising outlook for use of these services post the COVID-19 pandemic. Future studies should continue to review the acceptance of these services and their comparative impact on care outcomes. CLINICALTRIAL This trial is not currently registered since it was not an randomized controlled trial.