A study from Penn Medicine found that the increased use of telehealth during the COVID-19 pandemic may improve access to treatment for those with opioid use disorders, but remains less effective than in-person care.
The study, published on Nov. 25, analyzes the experiences of opioid use disorder treatment-providers using telehealth during the COVID-19 pandemic. Penn Medicine researchers interviewed 22 OUD treatment prescribers and staff at low-barrier, outpatient treatment programs in Philadelphia, Penn Nursing reported.
Philadelphia's opioid crisis has only worsened during the pandemic, with fatal overdoses in Philadelphia up by approximately 10% in the first six months of 2021 compared to the same time period in 2020. While the epicenter of the crisis is in Kensington, overdose deaths have also risen in West Philadelphia, particularly for Black and Hispanic residents.
“This has been an intensely stressful two years, causing people to lose access to the supports they would have,” spokesperson for the Philadelphia Department of Public Health James Garrow told The Philadelphia Inquirer.
The study found that due to financial difficulties, social isolation, and medical service closure, the COVID-19 pandemic has made it harder for people to access in-person opioid use disorder care, Penn Nursing reported. As a result, the Drug Enforcement Agency has temporarily allowed the remote initial prescription of controlled substances. Since many treatment programs rely on buprenorphine, the ability to prescribe this medication remotely has increased telehealth use.
“Telehealth may address many access issues. However, barriers to implementation remain, including patient ability and desire to attend healthcare appointments virtually,” lead-investigator and assistant professor in Penn Nursing’s Department of Family and Community Health Shoshana Aronowitz told Penn Nursing.
According to the study, telehealth can contribute to a digital divide as some patients lack access to technology or computer literacy necessary for virtual appointments. Clinicians may prefer in-person health care if patients are deemed “unstable” or for other reasons.
“I like to connect with my patients in the room, the body language. It’s hard, right? We like can’t give hugs. That’s what we do,” one prescriber who participated said in the Penn Medicine study.
While other potential solutions like financial incentives may also improve equitable access to opioid use disorder treatment, researchers of the study advocated for improving technology access for marginalized individuals and endorsing patient choice regarding potential treatment options.
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