Telehealth for opioid use disorder: retention as a function of demographics and rurality. (4th March 2023)

• Record Type: Journal Article
• Authors: Williams, Arthur Robin; Aronowitz, Shoshana V.; Rowe, Christopher; Gallagher, Ryan; Behar, Emily; Bisaga, Adam
• Is Part Of: American journal of drug and alcohol abuse. Volume 49:Number 2(2023)
• Page Start: 260
• Page End: 265
• Publication Date: 2023-03-04
• Subjects: Opioid use disorder -- buprenorphine -- telehealth -- quality measures; Drug abuse -- Treatment -- Periodicals; Alcoholism -- Treatment -- Periodicals; Substance-abuse -- Treatment -- Periodicals; Alcoholism -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86
• DOI: 10.1080/00952990.2023.2180382
• Languages: English
• ISSNs: 0095-2990

Abstract

ABSTRACT: Background: Despite lifesaving medications such as buprenorphine and methadone, the majority of individuals with opioid use disorder (OUD) face access barriers to evidence-based treatment. COVID-19 era regulatory reforms have shown that telehealth can improve access to care, although disparities in clinical outcomes are likely to persist. Objective: We aimed to analyze 180-day and 365-day retention in treatment with buprenorphine for OUD overall and by demographics, hypothesizing that retention would be lower among racial/ethnic minorities and rural patients. Methods: We analyzed data from a cohort of individuals with OUD enrolled in treatment from April 1, 2020 to September 30, 2021, in Pennsylvania and New York using a virtual-first telehealth OUD treatment platform to assess rates of 180-day and 365-day retention. Associations between demographic characteristics and retention were assessed using unadjusted and adjusted logistic regression models. Results: Among 1, 378 patients (58.8% male), 180-day retention was 56.4%, and 365-day retention was 48.3%. Adjusted analyses found that only an association between older age and greater odds of 180-day retention was significant (aOR for patients aged 30–50 vs. <30: 1.83 [1.37–2.45]). There were no significant associations between sex, race/ethnicity, state, or rurality with retention. Conclusion: While we were unable to control for socioeconomic variables, we found retention within telehealth services for buprenorphine was high irrespective of geography or race/ethnicity, but disparities with age indicate a subset of patients who may benefit from more intensive services early in care.