Implementing a low-threshold audio-only telehealth model for medication-assisted treatment of opioid use disorder at a community-based non-profit organization in Washington, D.C.

Harm Reduction Journal

Hana Akselrod¹  Jillian Catalanotti¹  David Sternberg²  Dana McCullough²  Ajetha Nadanasabesan²  Richard Mayo²  Ellis Jaewon Yeo³  Hannah Kralles³ 

[1] Department of Medicine, The George Washington University, 2150 Pennsylvania Avenue, 20037, Washington, DC, USA;HIPS Clinic, 906 H Street, NE, 20002, Washington, DC, USA;HIPS Clinic, 906 H Street, NE, 20002, Washington, DC, USA;Washington AIDS Partnership, 1701 Rhode Island Ave NW, Suite 03-108, 20036, Washington, DC, USA;

关键词: Harm reduction;    Opioid use disorder;    Medication-assisted treatment;    Buprenorphine;    COVID-19;    Telehealth;   

DOI  :  10.1186/s12954-021-00578-1

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic has had especially devastating effects on people who use drugs. Due to pandemic protocols in the USA, medication-assisted treatment (MAT) regulations became more flexible, permitting our community-based nonprofit organization to transition its low-threshold MAT clinic to an audio-only telehealth model of care in 2020. Lessons learned have the potential to improve MAT delivery to people with OUD.Case presentationThis case study describes our transition from a low-threshold community-based in-person MAT clinic to an audio-only telehealth model. We extracted data from electronic health records to describe patient characteristics and to calculate treatment retention rates. Patients were predominantly male (74.4%) and black (90.6%). The mean age was 53 years old with more than half of the clients aged 55 or older. Less than half (42.3%) of the patients lived in stable housing. Patients commonly had self-reported comorbid conditions such as hypertension (35.4%), hepatitis C (23.5%), diabetes (11.9%), human immunodeficiency virus (HIV) (7.2%). A majority of patients (68.6%) reported engagement with behavioral health care. We measure the success of our intervention relative to published retention rates, both overall as well as for in-person and telehealth care. In-person retention rates at 90- and 180-days were substantially higher than telehealth retention rates (93.9% vs 68.4% and 91.5% vs 51.9%, respectively).ConclusionsLow-threshold medication-assisted treatment in the care of people with opioid use disorder is essential to increasing treatment access and continuity. We found that an audio-only telehealth model was viable. Although we had decreased retention rates following the transition to an audio-only telehealth model, our rates remained excellent compared to published values for in-person MAT care. We call for advocacy and regulations to support continued use of telehealth services throughout and beyond the COVID-19 pandemic.

【 授权许可】

CC BY