Telemedicine app found to improve retention rates in opioid utilize disorder treatment

Patients who began treatment for opioid utilize disorder through a telemedicine mobile app stayed in treatment for six months longer than those who began treatment in an in-person clinic, according to a modern study from Oregon Health & Science University.

A study published in Journal of Addiction and Substance Employ Treatmentis one of the first studies to compare the retention rate of patients treated remotely and in a classic doctor’s office.

The comparison was possible only because a federal waiver during the COVID-19 pandemic allowed doctors to start buprenorphine treatment via phone or tablet rather than an in-person visit. The waiver is set to expire at the end of this year, adding significance to the modern finding amid an illicit drug crisis that still kills more than 100,000 Americans a year.

This finding strengthens the notion that telemedicine is effective in initiating and maintaining treatment for people with opioid utilize disorder.”

Brian Chan, MD, MA, Senior Author, Associate Professor of Medicine (General Internal Medicine and Geriatrics), OHSU School of Medicine

The study was conducted from September 2021 to March 2023. Buprenorphine is a partial opioid receptor agonist that suppresses opioid withdrawal symptoms. It is one of three medications approved by the Food and Drug Administration to treat opioid utilize disorder.

Researchers studied 159 patients from two groups: one that began treatment through a telehealth-only platform and one that began treatment in an office setting, a classic approach. Both groups experienced relatively low rates of treatment discontinuation. However, the telehealth-only group maintained treatment at a higher level over six months. After adjusting for time, the study found that only 3.8% discontinued treatment in the telehealth-only group over six months, compared with 9.7% in the care-as-usual group.

“These results provide additional evidence that for some treatment-seeking patients, an in-person assessment to receive buprenorphine may not be necessary,” the authors write.

Chan said the study comes with some vital caveats.

First, most patients in both groups—all in Oregon and Washington—remained in treatment for six months, meaning retention was high regardless of which treatment modality they used. In addition, overall rates of employment and stable housing among participants in the telehealth-only group were slightly higher than those in the care-as-usual group.

“In-person visits still have value for some types of patients,” Chan said. “At the same time, telehealth reduces the risk of having to interrupt treatment if patients can’t make it to in-person visits.”

Boulder Care, a Portland-based company that provides telemedicine treatment for substance utilize disorders, provided study participants with access to telemedicine. In-person treatment was delivered through a mix of primary care, addiction treatment clinics, and community-based clinical practices.

“We continue to learn that telemedicine plays a critical role in high-quality addiction care,” said co-author Stephen Martin, MD, medical director of research, education and quality at Boulder Care. “This study contributes to the critical body of evidence that virtual-only care is impressively effective in helping patients achieve life-saving treatment and recovery.

“We hope policymakers move quickly to ensure it remains a continuing source of care for all Americans.”