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A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic
INTRODUCTION: We know very little about how the pandemic impacted outpatient alcohol use disorder (AUD) care and the role of telemedicine. METHODS: Using OptumLabs® Data Warehouse de-identified administrative claims, we identified AUD cohorts in 2018 (N = 23,204) and 2019 (N = 23,445) and examined o...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613781/ https://www.ncbi.nlm.nih.gov/pubmed/36334384 http://dx.doi.org/10.1016/j.jsat.2022.108920 |
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author | Busch, Alisa B. Mehrotra, Ateev Greenfield, Shelly F. Uscher-Pines, Lori Rose, Sherri Huskamp, Haiden A. |
author_facet | Busch, Alisa B. Mehrotra, Ateev Greenfield, Shelly F. Uscher-Pines, Lori Rose, Sherri Huskamp, Haiden A. |
author_sort | Busch, Alisa B. |
collection | PubMed |
description | INTRODUCTION: We know very little about how the pandemic impacted outpatient alcohol use disorder (AUD) care and the role of telemedicine. METHODS: Using OptumLabs® Data Warehouse de-identified administrative claims, we identified AUD cohorts in 2018 (N = 23,204) and 2019 (N = 23,445) and examined outpatient visits the following year, focusing on week 12, corresponding to the March 2020 US COVID-19 emergency declaration, through week 52. Using multivariable logistic regression, we examined the association between patient demographic and clinical characteristics and receipt of any outpatient AUD visits in 2020 vs. 2019. RESULTS: In 2020, weekly AUD visit utilization decreased maximally at the pandemic start (week 12) by 22.5 % (2019: 3.8 %, 2020: 3.0 %, percentage point change [95 % CI] = −0.86[−1.19, −0.05]) but was similar to 2019 utilization by mid-April 2020 (week 16). Telemedicine accounted for 50.1 % of AUD visits by early July 2020 (week 27). Individual therapy returned to 2019 levels within 1 week (i.e., week 13) whereas group therapy did not consistently do so until mid-August 2020 (week 31). Further, individual therapy exceeded 2019 levels by as much as 50 % starting mid-October 2020. The study found no substantial differences in visits by patient demographic or clinical characteristics. CONCLUSIONS: Among patients with known AUD, initial outpatient care disruptions were relatively brief. However, substantial shifts occurred in care delivery—an embrace of telemedicine but also more pronounced, longer disruptions in group therapy vs. individual and an increase in individual therapy use. Further research needs to help us understand the implications of these findings for clinical outcomes. |
format | Online Article Text |
id | pubmed-9613781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96137812022-10-28 A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic Busch, Alisa B. Mehrotra, Ateev Greenfield, Shelly F. Uscher-Pines, Lori Rose, Sherri Huskamp, Haiden A. J Subst Abuse Treat Article INTRODUCTION: We know very little about how the pandemic impacted outpatient alcohol use disorder (AUD) care and the role of telemedicine. METHODS: Using OptumLabs® Data Warehouse de-identified administrative claims, we identified AUD cohorts in 2018 (N = 23,204) and 2019 (N = 23,445) and examined outpatient visits the following year, focusing on week 12, corresponding to the March 2020 US COVID-19 emergency declaration, through week 52. Using multivariable logistic regression, we examined the association between patient demographic and clinical characteristics and receipt of any outpatient AUD visits in 2020 vs. 2019. RESULTS: In 2020, weekly AUD visit utilization decreased maximally at the pandemic start (week 12) by 22.5 % (2019: 3.8 %, 2020: 3.0 %, percentage point change [95 % CI] = −0.86[−1.19, −0.05]) but was similar to 2019 utilization by mid-April 2020 (week 16). Telemedicine accounted for 50.1 % of AUD visits by early July 2020 (week 27). Individual therapy returned to 2019 levels within 1 week (i.e., week 13) whereas group therapy did not consistently do so until mid-August 2020 (week 31). Further, individual therapy exceeded 2019 levels by as much as 50 % starting mid-October 2020. The study found no substantial differences in visits by patient demographic or clinical characteristics. CONCLUSIONS: Among patients with known AUD, initial outpatient care disruptions were relatively brief. However, substantial shifts occurred in care delivery—an embrace of telemedicine but also more pronounced, longer disruptions in group therapy vs. individual and an increase in individual therapy use. Further research needs to help us understand the implications of these findings for clinical outcomes. Elsevier Inc. 2023-01 2022-10-28 /pmc/articles/PMC9613781/ /pubmed/36334384 http://dx.doi.org/10.1016/j.jsat.2022.108920 Text en © 2022 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 Busch, Alisa B. Mehrotra, Ateev Greenfield, Shelly F. Uscher-Pines, Lori Rose, Sherri Huskamp, Haiden A. A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic |
title | A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic |
title_full | A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic |
title_fullStr | A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic |
title_full_unstemmed | A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic |
title_short | A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic |
title_sort | cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the united states during the covid-19 pandemic |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613781/ https://www.ncbi.nlm.nih.gov/pubmed/36334384 http://dx.doi.org/10.1016/j.jsat.2022.108920 |
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