Telehealth Bolsters Access to Opioid Use Disorder Treatment for Veterans

While evaluating methods to ensure access to opioid use disorder treatment among veterans, a study from the University of Michigan and VA Ann Arbor Healthcare System found that audio and video-based care modalities provide various benefits, such as increased access to buprenorphine.

At the start of the COVID-19 pandemic in 2020, many patients and providers feared that in-person restrictions would drive poor health outcomes. For example, there were concerns that veterans struggling with opioid addiction would have difficulties obtaining medications, like buprenorphine, during the pandemic.

However, following evaluation over two years, researchers found that telehealth has been just as effective, if not more effective, as in-person care in providing opioid use disorder treatment resources to this population.

The researchers examined access to buprenorphine treatment for opioid use disorder in the Veterans Health Administration, during the year before the COVID-19 pandemic (March 2019 to February 2020) and during the first year of the pandemic (March 2020 to February 2021).

Overall, the number of patients receiving buprenorphine increased from 13,415 in March 2019 to 15,339 in February 2021.

Although various telehealth modalities were commonly used, audio-only visits accounted for 50 percent of veteran visits relating to buprenorphine — eclipsing video visits, which accounted for 32 percent, and in-person visits, encompassing 17 percent of total visits.

“Telehealth for patients receiving buprenorphine for opioid use disorder was relatively new in the VA nationwide before the pandemic struck, and only video was allowed. The rapid switch to virtual visits for most patients kept people from dropping out of care, and telephone visits played a key role,” said Allison Lin, MD, an addiction psychiatrist and researcher in the Addiction Center at Michigan Medicine, U-M’s academic medical center, and the VA Center for Clinical Management Research, in a press release.

Researchers believe that the primary reason for audio telehealth's success is the ease patients experience using it, along with its accessibility.

But to continue telehealth optimization and outreach, pandemic-era regulatory flexibilities must be made permanent.

The elimination of regulatory restrictions on telehealth use that occurred at the start of the pandemic was initially intended to be temporary. However, policymakers are currently considering whether to remove the restrictions permanently, and data on telehealth use can help inform that decision-making.

The use of telehealth and mHealth devices to support opioid use disorder treatment has become increasingly common.

In May, the University of Virginia announced the development of an mHealth app that provides opioid use disorder patients with a message board service, allowing for accessible communication with providers. During the trial period, researchers observed that patients' use of the app was high.

However, health disparities may also exist in delivering opioid use disorder treatment. A Mayo Clinic study published in June showed that women, Black, and Hispanic populations often face difficulties accessing this type of care and that increasing the number of physicians prescribing buprenorphine is critical.