Telehealth-Enabled Observation Effective for At-Home Methadone Dosing

A study from the Journal of Substance Abuse Treatment found that video observation was an effective method in increasing rates of observed methadone dosing while limiting exposure to respiratory illness and breaking down barriers linked to the face-to-face observation of dosing.

According to the study, methadone is a prevalent method for treating opioid use disorder. Traditionally, observing methadone dosing requires face-to-face communication between a patient and a provider. However, largely because of the pandemic, providers noticed that this type of visitation could put people at risk of contracting respiratory illnesses, such as COVID-19.

This study aimed to determine the ease that video observation may bring to the process of observing methadone dosages as well as its effectiveness. From April to August 2020, researchers conducted a clinical pilot program that involved video observation of methadone take-home dosing using smartphone devices.

After participating in a COVID-19 symptom screener, patients were asked to record themselves taking methadone doses at home. After two weeks, those who followed the instructions went on to participate in the entire pilot program, receiving additional take-home methadone doses. Of the 44 patients who participated in the two-week trial program, 33 (75 percent) passed on to the next stage.

Of the 33 patients, 20 (61 percent) obtained increased take-home doses. Researchers found that those who participated in the full pilot program had a higher number of observed dosing days over a 60-day period compared to matched controls.

Based on this data, researchers found that video observation of methadone dosing was effective. Not only did this care method display the potential to treat patients effectively, but it also provided additional benefits, such as increased patient safety due to limited exposure to COVID-19.

Throughout the COVID-19 pandemic, many organizations have experimented with various methods of at-home care.

In October, three organizations formed a partnership to develop a comprehensive care-at-home services program. The program aims to increase patient comfort and convenience through various at-home treatment options for recovery, rehabilitation, palliative care, primary care, and home health.

Another collaboration announced in August resulted in the creation of a hospital-at-home program. To support acute care delivery at home, the organizations involved in the partnership offered various care services that included telehealth and in-person visits to patients in their homes.

Also in August, a group of 18 health systems announced that they would work together to create a set of home hospital tools. Known as the Home Hospital Early Adopters Accelerator, the program included various representatives from the US and South Africa. In addition to the tools, the group also aimed to create a system for identifying patients eligible for at-home care.

Further, calls for continued virtual access to controlled substance prescriptions after the pandemic have grown.

In April, two US senators wrote a letter to the Drug Enforcement Administration and the Department of Health and Human Services that included a request for continued telehealth access to prescriptions for controlled substances after the COVID-19 pandemic has ended.