Penn Medicine Telehealth Program Improves Access to OUD Treatment 

As described in NEJM Catalyst, a program known as CareConnect created by the Perelman School of Medicine at the University of Pennsylvania uses telehealth to assist opioid use disorder (OUD) patients in accessing care, resulting in more buprenorphine prescriptions and fewer care access barriers.

According to the Centers for Disease Control and Prevention (CDC), opioids can be prescribed to treat chronic and acute pain, leading to positive outcomes when used appropriately. However, various risks are also associated with these substances, as patients can develop addictions that may lead to overdose.

However, through CareConnect, Penn Medicine aimed to virtually assess OUD patients and provide prescriptions for buprenorphine, a drug that reduces opioid cravings and treats withdrawal symptoms. CareConnect is a partnership between Penn Medicine OnDemand, the health system's virtual urgent care service, and substance use navigators.

Launched in November 2021, the program has received 371 calls and provided 249 buprenorphine prescriptions through September 2022.

According to an assessment conducted by Penn Medicine, 89 percent of program participants filled their first buprenorphine prescription during that period, and 55 percent continued a preexisting prescription for the medication at least 30 days after being engaged, indicating that they continued their treatment.

“When we compare our numbers to other transitional treatment models, our program stacks up pretty well, especially when you consider we’re seeing a lot of patients with unstable housing, recent hospital admissions, and other markers of instability,” said Nicole O’Donnell, a co-author of the study and a peer recovery specialist with the Penn Center for Addiction Medicine and Policy (CAMP), in the press release.

Along with the success of CareConnect in providing buprenorphine, it helped eliminate barriers to care, the press release notes. During the COVID-19 pandemic, standard regulations for prescribing buprenorphine were suspended. CAMP launched a pilot telehealth program prior to CareConnect, which provided short-term prescriptions for OUD medications such as buprenorphine. This enabled patients, who might typically receive care in emergency departments, to avoid traveling to the facility. CareConnect is a broader version of the pilot.

“The strength of a program like this is in the ways it fills all of the gaps: For an average patient seeking treatment, there are few — if any — places that can offer treatment on the same or next day, and even then, patients have to manage a variety of barriers such as childcare or transportation,” said the study’s lead author Margaret Lowenstein, MD, an assistant professor of Medicine and the research director of CAMP, in a press release. “CareConnect allows patients to get their prescription for buprenorphine as soon as they need it and provides the help needed to navigate all of the hurdles a patient faces until they can be stably linked to care.”

More research from September provided insight into how the expansion of telehealth during the COVID-19 pandemic led to an increase in the use of medications for OUD.

Published in JAMA Psychiatry, the study involved researchers dividing patients into two cohorts: one that received care before the pandemic and another during the pandemic. Their research found that among the pandemic group, the use of telehealth services correlated with a higher likelihood of patients remaining in programs that provided medications for OUD. Telehealth use was also associated with a lower likelihood of medically treated overdoses.