Telehealth Supported Opioid Use Disorder Treatment at Safety-Net Clinic

As healthcare became increasingly virtual during the COVID-19 pandemic, telehealth helped safety-net facilities provide opioid use disorder (OUD) patients, particularly those involved in buprenorphine treatment programs, high levels of care, according to a new study.  

The study took place at a south-central Pennsylvania-based federally qualified health center (FQHC). The location treats about 56,000 patients, 60 percent of whom come from rural areas.

This FQHC provides a Medications for OUD (MOUD) with buprenorphine program at various clinics, including family medicine, women's care, and behavioral health care sites. The treatment program consists of visits that range from weekly to monthly.

Researchers collected information, including visit dates, progress notes, urine drug tests, current and prior buprenorphine formulation, and dosage, to conduct a retrospective chart review.

To compare the effects that the COVID-19 pandemic and telehealth had on treatment retention, researchers collected patient information from four time periods, each of which spanned about three months. Some were prior and some were during the pandemic.

Before the pandemic, all patient visits were conducted in person. The visits were conducted via telehealth during the pandemic due to COVID-19 social-distancing guidelines.

Treatment retention rates for the groups in all four time periods fell within the 90 percent range, implying that each program was effective, whether it was conducted through telehealth or in-person. The during-COVID group experienced a treatment retention rate of 90.83 percent, slightly below the pre-COVID treatment retention rate of 94.18 percent.

Considering that the retention rate for MOUD programs can be as low as 19 percent after three months, researchers found the MOUD with buprenorphine treatment rates impressive.

Though researchers noted several limitations associated with their work, including that the data regarding the rural setting of this FQHC is hard to generalize, they concluded that telehealth was "efficacious in retaining patients in MOUD with buprenorphine treatment programs during the COVID-19 pandemic."

To promote the treatment of opioid use disorders, the Department of Health and Human Services issued a grant of $1.5 billion in 2020. The grant was intended to support various treatment programs, including medication-assisted treatment therapy and innovative telehealth strategies.

Despite high efficacy levels of virtual opioid use disorder treatment, lack of access to technology can often serve as a barrier.

A study published in November 2021 from the University of Pennsylvania explored the effects of telehealth on opioid use disorder treatment and established three main takeaways from their research. First, the use of telehealth could exacerbate the digital divide between those who were comfortable with technology and those who were not. Second, the decision about whether to use telehealth is often based on the clinician's perception of stability. Finally, patients may not have extensive access to technology.