Tuesday, October 19, 2021

Survey Highlights Strengths and Challenges of Telehealth for Addiction

Telehealth may help to engage more patients in addiction treatment by improving access and convenience, but there is limited evidence that patients with substance use disorder benefit more from services delivered via telehealth than in-person care, concluded a report in Psychiatric Services in Advance.

“The COVID-19 public health crisis forced the addiction treatment system to pivot from delivering most addiction treatment in person to delivering treatment via telehealth,” wrote Tami L. Mark, Ph.D., M.B.A. of RTI International in Rockville, Md., and colleagues. They noted that federal and state agencies temporarily eased many telehealth restrictions to enable this transition. “Of special relevance to addiction treatment are requirements for in-person visits to prescribe buprenorphine and for in-person intake and physical exam to initiate methadone treatment. Policymakers and payers are now considering which of these flexibilities should be maintained.”

Mark and colleagues first conducted a literature review comparing the effectiveness of in-person addiction treatment with telehealth (telephone or videoconferencing for assessment, diagnosis, and/or treatment). Of the eight studies identified, seven found no significant differences between these two modalities for outcomes such as treatment retention, treatment satisfaction, substance use rates, or the strength of the therapeutic alliance. However, one observational study reported that telehealth facilitated methadone prescribing and improved treatment retention among patients with opioid use disorder.

The researchers next conducted an online survey of leaders at addiction treatment organizations throughout California and received 100 responses. The results indicated that addiction professionals were evenly split with regard to the effectiveness of telehealth versus in-person individual counseling; 46% said that telehealth was equal to or more effective than in-person care, and 45% said that telehealth was less effective than in-person care. However, there was less support for telehealth in group counseling; 62% said it was less effective than in-person group therapy while only 25% said telehealth group therapy was equal to or more effective than in-person care. More than half of the respondents said that they believed telehealth was less effective than in-person care for providing intensive outpatient treatment or medication management.

“Telehealth may allow patients to more easily begin and stay in addiction treatment, which has been a longstanding challenge,” said Mark in a news release. “However, research is needed to confirm this benefit. As providers pivot to hybrid telehealth models—offering both telehealth and in-person treatment—they need information to help target telehealth to the most appropriate services and patients.”

To read more on this topic, see the Psychiatric News article “Telehealth Options for Treating Patients With SUD Expand.”

(Image: iStock/anyaberkut)

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