Thursday, July 20, 2023

Study Suggests Few Disruptions in Treatment for OUD During the Pandemic

Disruptions in health care services during the COVID-19 pandemic did not significantly reduce the ability of adults to remain in treatment for opioid use disorder (OUD), suggests a report published this week in Psychiatric Services. The authors believe that access to telehealth services was partially responsible for the continuation of care during this period.

“Among a group of adults with commercial insurance or Medicare Advantage who had received opioid use disorder treatment before the COVID-19 pandemic, we observed minimal changes in outpatient and [medications for OUD] treatment utilization in the 2 years after pandemic onset,” wrote Kayla N. Tormohlen, Ph.D., M.P.H., of Johns Hopkins Bloomberg School of Public Health and colleagues. The authors noted it is unclear if the same applies to patients covered by Medicaid and patients without insurance.

The researchers analyzed deidentified administrative insurance claims for adults aged 18 or older who were covered by commercial insurance or Medicare Advantage from March 2018 to February 2022. To compare OUD treatment trends before the start of the pandemic with those in the years that followed, only patients who had an insurance claim indicating inpatient or outpatient treatment for OUD between March 2018 and February 2019 were included in the analysis. The final sample included 13,113 adults.

In March 2019, 10.6% of the patients had an OUD outpatient visit; by February 2022, 7.8% of the patients had an OUD outpatient visit—a decline of 2.8 percentage points, Tormohlen and colleagues reported. The proportion of patients receiving medication for OUD declined by 0.3 percentage points from March 2019 to February 2022.

Other findings included the following:

  • Between March 2019 and February 2020, 98.6% of the patients who received outpatient opioid use disorder treatment obtained care via in-person settings only.
  • Between March 2020 and February 2021, 46.0% of the patients received at least some opioid use disorder treatment via telehealth, 34.6% received a combination of telehealth and in-person care, and 11.4% received telehealth services only.
  • Between March 2021 and February 2022, 34.9% of the patients received at least some outpatient care via telehealth, 23.4% received both telehealth and in-person care, and 11.5% received care via telehealth only.

“[T]he pandemic spurred widespread policy changes, including flexibility in the delivery of telehealth for opioid use disorder treatment, that may have enhanced treatment access,” they wrote. Even with these policy changes, however, the researchers noted that the “findings suggest that telehealth did not completely replace in-person services for opioid use disorder in either the first year of the COVID-19 pandemic or 2 years after its onset.”

They concluded, “Future research may examine how these policies affect receipt of care and explore how to optimally target in-person, telehealth, or a combination of treatment modalities to patients with opioid use disorder.”

For related information, see the Psychiatric News articles “Expanded Buprenorphine Prescribing Authority Gains Traction During Pandemic” and “Pandemic Creates Challenges, New Opportunities for Treating Patients With Substance Use Disorder.”

(Image: iStock/dusanpetkovic)

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