75% of Doctors Worry Telehealth Blocks Visibility Into Addiction Issues

Though telehealth has increased access to care in a myriad of ways, a majority of physicians are worried that it does not give them the full picture of patient health ­— especially with regard to prescription drug misuse, according to a new report.

Released by clinical laboratory Quest Diagnostics, the report includes responses from a survey conducted between Aug. 12 and 19 that polled 505 physicians specializing in family practice, general practice or internal medicine. Nearly all respondents (97%) said they had prescribed opioids or other controlled medications within six months of taking the survey.

Further, the report combines the survey responses with an analysis of nearly 5 million de-identified Quest Diagnostics test results.

One of the most eye-opening findings from the survey is that 75 percent of physicians said telehealth visits limited their ability to determine if patients are at risk for or are already misusing prescription drugs.

Though most of the physicians (91 percent) felt confident that they could recognize the signs of drug misuse during in-person interactions with patients, only 50 percent reported the same level of confidence during telehealth interactions.

"We know telehealth was a lifeline for so many during the pandemic, but this finding reinforces that there may be limitations to the technology when dealing with drug misuse disorders specifically," said Dr. Harvey W. Kaufman, senior medical director and director of the health trends research program for Quest Diagnostics, in an email. "This is likely because clinical drug testing, which typically involves urine analysis, is difficult to implement in a virtual environment."

About 88 percent of the physicians polled believe that clinical drug testing is key to preventing drug misuse. But there was a 70 percent drop in testing volumes between March and May 2020, Quest Diagnostics data shows.

Physicians are worried that the COVID-19 pandemic has exacerbated the prescription drug crisis. Approximately 71 percent of physicians said that the pandemic has made the crisis worse than it was.

This notion is borne out by the latest figures from the Centers for Disease Control and Prevention. Drug overdose deaths rose by nearly 29 percent to more than 100,000 from April 2020 to April 2021 — a record high.

Around 76 percent of physicians believe that drug overdose deaths will continue to rise even as the pandemic subsides.

Nearly all of the physicians surveyed said they talk to patients who are prescribed a controlled substance about the dangers of drug misuse (96 percent) or potentially dangerous drug combinations (98 percent).

Additionally, 88 percent of physicians feel confident that they can identify patients at risk for drug misuse.

According to the analysis of 475,000 de-identified lab test results in 2020, nearly half of all patients (48 percent) showed signs of misuse.

Further, a majority of physicians (78 percent) said they want more information on how to monitor for prescription drug addiction and more training on what to do if a patient is showing signs of addiction.

"This research underscores the need to arm physicians with the resources on how and when to employ optimal drug monitoring, including guidance on how to use telehealth to care for patients taking controlled prescription medications," Quest Diagnostics' Kaufman said.