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Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study
OBJECTIVES: During the COVID-19 pandemic, opioid treatment programs (OTPs) in the U.S. were granted new flexibility in methadone dispensing and the use of telemedicine. To explore the impact of the pandemic and accompanying policy changes on service delivery, we asked OTP clinicians about changes in...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833320/ https://www.ncbi.nlm.nih.gov/pubmed/33771285 http://dx.doi.org/10.1016/j.jsat.2021.108288 |
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author | Hunter, Sarah B. Dopp, Alex R. Ober, Allison J. Uscher-Pines, Lori |
author_facet | Hunter, Sarah B. Dopp, Alex R. Ober, Allison J. Uscher-Pines, Lori |
author_sort | Hunter, Sarah B. |
collection | PubMed |
description | OBJECTIVES: During the COVID-19 pandemic, opioid treatment programs (OTPs) in the U.S. were granted new flexibility in methadone dispensing and the use of telemedicine. To explore the impact of the pandemic and accompanying policy changes on service delivery, we asked OTP clinicians about changes in care patterns and perceptions of impacts on access and quality. METHODS: In May–June 2020, we completed semistructured telephone interviews with 20 OTP clinicians (physicians, physician assistants, and nurse practitioners) from 13 U.S. states. The study recruited participants through Medscape, an online platform where clinicians access clinical content. We used rapid thematic analysis, a qualitative approach, to summarize participants' expressed views related to the research objectives. RESULTS: Clinicians identified a range of changes to methadone and ancillary service delivery as a result of COVID-19. Most clinicians reported that OTPs were prescribing more take-home doses of methadone and providing psychosocial services and medication management via telemedicine. Many also reported reducing the frequency of urine toxicology screening and accepting fewer new patients. While some clinicians expressed support for the increased flexibility around dosing and use of telemedicine, others expressed concern about increased risk of medication diversion and overdose. Clinicians reported several advantages and disadvantages of the changes due to the pandemic and that continued reimbursement would be required to maintain telemedicine services. CONCLUSIONS: The COVID-19 pandemic dramatically altered the delivery of methadone treatment in the U.S. This study's findings suggest that OTPs may have reduced their methadone treatment during the early months of the pandemic and that the flexibilities that policy changes offered may not have resulted in changes in care delivery for all patients. Careful consideration and additional analysis should inform which changes OTPs should maintain long-term. |
format | Online Article Text |
id | pubmed-7833320 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78333202021-01-26 Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study Hunter, Sarah B. Dopp, Alex R. Ober, Allison J. Uscher-Pines, Lori J Subst Abuse Treat Article OBJECTIVES: During the COVID-19 pandemic, opioid treatment programs (OTPs) in the U.S. were granted new flexibility in methadone dispensing and the use of telemedicine. To explore the impact of the pandemic and accompanying policy changes on service delivery, we asked OTP clinicians about changes in care patterns and perceptions of impacts on access and quality. METHODS: In May–June 2020, we completed semistructured telephone interviews with 20 OTP clinicians (physicians, physician assistants, and nurse practitioners) from 13 U.S. states. The study recruited participants through Medscape, an online platform where clinicians access clinical content. We used rapid thematic analysis, a qualitative approach, to summarize participants' expressed views related to the research objectives. RESULTS: Clinicians identified a range of changes to methadone and ancillary service delivery as a result of COVID-19. Most clinicians reported that OTPs were prescribing more take-home doses of methadone and providing psychosocial services and medication management via telemedicine. Many also reported reducing the frequency of urine toxicology screening and accepting fewer new patients. While some clinicians expressed support for the increased flexibility around dosing and use of telemedicine, others expressed concern about increased risk of medication diversion and overdose. Clinicians reported several advantages and disadvantages of the changes due to the pandemic and that continued reimbursement would be required to maintain telemedicine services. CONCLUSIONS: The COVID-19 pandemic dramatically altered the delivery of methadone treatment in the U.S. This study's findings suggest that OTPs may have reduced their methadone treatment during the early months of the pandemic and that the flexibilities that policy changes offered may not have resulted in changes in care delivery for all patients. Careful consideration and additional analysis should inform which changes OTPs should maintain long-term. Elsevier Inc. 2021-05 2021-01-13 /pmc/articles/PMC7833320/ /pubmed/33771285 http://dx.doi.org/10.1016/j.jsat.2021.108288 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Hunter, Sarah B. Dopp, Alex R. Ober, Allison J. Uscher-Pines, Lori Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study |
title | Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study |
title_full | Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study |
title_fullStr | Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study |
title_full_unstemmed | Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study |
title_short | Clinician perspectives on methadone service delivery and the use of telemedicine during the COVID-19 pandemic: A qualitative study |
title_sort | clinician perspectives on methadone service delivery and the use of telemedicine during the covid-19 pandemic: a qualitative study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833320/ https://www.ncbi.nlm.nih.gov/pubmed/33771285 http://dx.doi.org/10.1016/j.jsat.2021.108288 |
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