1. Care coordination between rural primary care and telemedicine to expand medication treatment for opioid use disorder: Results from a single-arm, multisite feasibility study.
- Author
-
Hser, Yih-Ing, Mooney, Larissa, Baldwin, Laura-Mae, Ober, Allison, Marsch, Lisa, Sherman, Seth, Matthews, Abigail, Clingan, Sarah, Fei, Zhe, Dopp, Alex, Curtis, Megan, Osterhage, Katie, Hichborn, Emily, Lin, Chunqing, Black, Megan, Calhoun, Stacy, Holtzer, Caleb, Nesin, Noah, Bouchard, Denise, Ledgerwood, Maja, Gehring, Margaret, Liu, Yanping, Ha, Neul, Murphy, Sean, Hanano, Maria, Saxon, Andrew, and Zhu, Yuhui
- Subjects
care coordination ,medication for opioid use disorder ,opioid use disorder ,primary care ,rural community ,telemedicine ,Humans ,COVID-19 ,Feasibility Studies ,Pandemics ,Opioid-Related Disorders ,Telemedicine ,Primary Health Care - Abstract
PURPOSE: The use of telemedicine (TM) has accelerated in recent years, yet research on the implementation and effectiveness of TM-delivered medication treatment for opioid use disorder (MOUD) has been limited. This study investigated the feasibility of implementing a care coordination model involving MOUD delivered via an external TM provider for the purpose of expanding access to MOUD for patients in rural settings. METHODS: The study tested a care coordination model in 6 rural primary care sites by establishing referral and coordination between the clinic and a TM company for MOUD. The intervention spanned approximately 6 months from July/August 2020 to January 2021, coinciding with the peak of the COVID-19 pandemic. Each clinic tracked patients with OUD in a registry during the intervention period. A pre-/post-intervention design (N = 6) was used to assess the clinic-level outcome as patient-days on MOUD based on patient electronic health records. FINDINGS: All clinics implemented critical components of the intervention, with an overall TM referral rate of 11.7% among patients in the registry. Five of the 6 sites showed an increase in patient-days on MOUD during the intervention period compared to the 6-month period before the intervention (mean increase per 1,000 patients: 132 days, P = .08, Cohens d = 0.55). The largest increases occurred in clinics that lacked MOUD capacity or had a greater number of patients initiating MOUD during the intervention period. CONCLUSIONS: To expand access to MOUD in rural settings, the care coordination model is most effective when implemented in clinics that have negligible or limited MOUD capacity.
- Published
- 2023