Assessing the Impact of Telehealth Delivery on Adherence to Medications for Opioid Use Disorder

Speaker(s)

Wang Y1, Shi L2, Bogulski C3, Hayes C4, Bledsoe A5, Winston KD4, Meggett K1, Eswaran H3
1Clemson University, Clemson, SC, USA, 2Pace University, Albertson, NY, USA, 3University of Arkansas for Medical Sciences, Little Rock, AR, USA, 4University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA, 5Emory University, Atlanta, GA, USA

OBJECTIVES: Medications for Opioid Use Disorder (MOUD) could reduce OUD mortality, yet MOUD adherence rates remain suboptimal. While it is plausible that telehealth MOUD service might reduce the stigma and inconvenience associated with routine MOUD visits, the empirical evidence remains inconclusive on whether telehealth improves MOUD adherence. In this study, we used claims data to examine whether telehealth utilization was associated with stronger MOUD adherence.

METHODS: We performed an analysis of 2020 MarketScan data for 101,427 OUD patients. We use a Zero-inflated negative binomial (ZINB) model to compare the MOUD visit frequency (including both telehealth-delivered and in-person MOUD service) April-June 2020 between 38,746 patients who used any telehealth service (including telehealth-delivered primary care visits) and 26,633 patients who never used any telehealth for those three months, adjusting for patient-level demographic characteristics. We then compared the difference in MOUD visits from July to December 2020 between these two groups of patients.

RESULTS: Compared with those who did not use any telehealth service, telehealth users were more likely to have at least one MOUD visit (Odds ratio: 1.217, p<0.0001) and had more MOUD visits among those who had at least one MOUD visit (Incident Rate Ratio: 1.027, p=0.0213) from April to June. From July to December, those telehealth users were still more likely to have at least one MOUD visit (O.R.=1.253, p<0.0001) yet their advantage in the frequency of MOUD visits among those who at least had one MOUD visit was no long significant. Risk factors associated with fewer MOUD visits include younger age, male gender, non-urban residence and non-fulltime employment status.

CONCLUSIONS: Pandemic-time telehealth utilization was found to be positively associated with more MOUD visits, a promising sign that using telehealth service might facilitate adherence to this life-saving treatment, especially at a time of “twin-demic” (spike of OUD and Covid-19 incidence).

Code

HSD54

Topic

Epidemiology & Public Health, Study Approaches

Topic Subcategory

Public Health

Disease

Drugs, No Additional Disease & Conditions/Specialized Treatment Areas