New research from UPMC reveals that their telehealth bridge clinic has been a game-changer for high-risk opioid use disorder (OUD) patients, making treatment more accessible and engaging. The study, published in the Journal of Addiction Medicine, delves into the effectiveness of this clinic established by UPMC following a temporary relaxation of restrictions on telehealth-enabled buprenorphine treatment by the US Drug Enforcement Administration (DEA).
During the COVID-19 public health emergency, the DEA lifted the requirement for an initial in-person evaluation before prescribing controlled substances via telehealth, including buprenorphine. UPMC seized this opportunity to set up a telehealth bridge clinic, offering hassle-free access to substance use disorder treatment.
The clinic connects OUD patients in Pennsylvania with board-certified physicians in emergency medicine, toxicology, and addiction medicine via audio-visual technology or telephone. These physicians conduct remote evaluations and prescribe buprenorphine and naloxone nasal spray to eligible patients.
The study reveals some impressive statistics. Over 200 patients scheduled appointments at the clinic from April 27, 2020, to July 31, 2021, with a whopping 96% attending their appointments. Among these, OUD patients made up 96% of the visits. Most patients (79%) opted for audio-only appointments, and the majority were covered by Medicaid (62%).
Of the 192 OUD patients who attended telehealth appointments, 96% filled their buprenorphine prescription within 30 days, and 77% filled two or more prescriptions thereafter. Notably, there was no significant difference in prescription fills between patients evaluated via video or audio-only telehealth.
The researchers emphasize the clinic's potential for integration into existing addiction care frameworks, including behavioral therapy and social supports. They argue that telemedicine clinics offer cost-effective, scalable solutions for treating patients who lack rapid access to local care.
The study coincides with the Department of Health and Human Services (HHS) final rule, which expands access to OUD medications. This rule makes permanent several pandemic-era flexibilities, including the use of telehealth to initiate buprenorphine treatment.
However, recent research has presented conflicting views on the impact of telehealth on OUD care. While some studies suggest high retention rates and reduced overdose risks with telehealth, others question its ability to improve OUD treatment quality and access.
Despite the debate, UPMC's telehealth bridge clinic stands as a beacon of hope, revolutionizing OUD treatment and offering a lifeline to vulnerable patients.
a client is undergoing inpatient addiction rehabilitation following many years or addiction to heroin. what medication would be the most useful adjunct to treatment?