Advancing virtual primary care for people with opioid use disorder (VPC OUD): a mixed-methods study protocol

Hedden, Lindsay; McCracken, Rita; Spencer, Sarah; Narayan, Shawna; Gooderham, Ellie; Bach, Paxton; Boyd, Jade; Chakanyuka, Christina; Hayashi, Kanna; Klimas, Jan; Law, Michael R.; McGrail, Kimberlyn; Nosyk, Bohdan; Peterson, Sandra; Sutherland, Cindy; Ti, Lianping; Yung, Seles; Cameron, Fred; Fernandez, Renee; Giesler, Amanda; Strydom, Nardia

doi:10.1136/bmjopen-2022-067608

Cited by 4 publications

(4 citation statements)

References 49 publications

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“…Furthermore, our definition of virtual visits excluded asynchronous forms, and we did not consider care settings providing only OAT. This criterion was in place to align with our broader research project [36] and to maintain a manageable review size. Additionally, studies published in languages other than English were not captured.…”

Section: Discussionmentioning

confidence: 99%

“…This review informs a mixed-methods study investigating changes to primary care access and patient outcomes following the rapid introduction of virtual care for PWOUD in British Columbia, Canada [36]. We conducted the review in accordance with the Joanna Briggs Institute Reviewer Manual [37,38] and the framework suggested by Arksey and O'Malley [39].…”

Section: Overall Study Designmentioning

confidence: 99%

“…Furthermore, virtual care implementation within organizations fluctuated due to staff turnover or equipment changes. Brief Report [107] [70, 75] Protocol [36] Review [108] QuADS: Quality Assessment with Diverse Studies…”

Section: Sivakumar Et Al [67]mentioning

confidence: 99%

“…Hedden et al [36] Understand the impact of expanded virtual primary care on provision of, access to, and health outcomes of PWOUD.…”

mentioning

confidence: 99%

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Virtual Primary Care for People with Opioid Use Disorder: A Scoping Review of Current Strategies, Benefits, and Challenges

Narayan,

Gooderham,

Spencer

et al. 2023

Preprint

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BackgroundThere is a pressing need to understand the implications of the rapid adoption of virtual primary care for people with opioid use disorder. Potential impacts, including disruptions to opiate agonist therapies, and the prospect of improved service accessibility remain underexplored. This scoping review synthesizes current literature on virtual primary care for people with opioid use disorder, with a specific focus on benefits, challenges, and strategies.MethodsWe followed the Joanna Briggs Institute methodological approach for scoping reviews and reported our findings consistent with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We conducted searches on MEDLINE, Web of Science, CINAHL Complete, and Embase using our developed search strategy with no date restrictions. We incorporated all study types that included the three concepts (i.e., virtual care; primary care; people with opioid use disorder). We excluded research on minors, asynchronous virtual modalities, and care not provided in a primary care setting. We used Covidence to screen and extract data, pulling information on study characteristics, health system features, patient outcomes, and challenges and benefits of virtual primary care. We conducted inductive content analysis and calculated descriptive statistics. We appraised the quality of studies using the Quality Assessment with Diverse Studies tool and categorized findings using the Consolidated Framework for Implementation Science.ResultsOur search identified 1474 studies. We removed 536 duplicates, leaving 936 studies for title and abstract screening. After a double review process, we retained 28 studies for extraction. Most studies described virtual primary care delivered via phone (n=18, 64.3%) rather than video. While increased healthcare accessibility was a significant benefit (n=13, 46.4%) to the adoption of virtual visits, issues around access to technology and digital literacy stood out as the main challenge (n=12, 42.9%).ConclusionsThe available studies highlight the potential for enhancing accessibility and continuous access care for people with opioid use disorder using virtual modalities. Future research and policies must focus on bridging gaps to ensure virtual primary care does not exacerbate or entrench health inequities.

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Section: Discussionmentioning

confidence: 99%

Section: Overall Study Designmentioning

confidence: 99%

Section: Sivakumar Et Al [67]mentioning

confidence: 99%

“…Hedden et al [36] Understand the impact of expanded virtual primary care on provision of, access to, and health outcomes of PWOUD.…”

mentioning

confidence: 99%

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Virtual Primary Care for People with Opioid Use Disorder: A Scoping Review of Current Strategies, Benefits, and Challenges

Narayan,

Gooderham,

Spencer

et al. 2023

Preprint

Self Cite

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Understanding the use of telemedicine across different opioid use disorder treatment models: A scoping review

Tay Wee Teck,

Butner,

Baldacchino

2023

J Telemed Telecare

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Introduction The COVID-19 pandemic has instigated the development of telemedicine-mediated provision of medications for opioid use disorder such as buprenorphine and methadone, referred to as TMOUD in this study. As services start to return to pre-pandemic norms, there is a debate around the role of TMOUD as addition to or replacement of the conventional cascade of care for people with opioid use disorder (PWOUD). This scoping review is designed to characterize existing TMOUD services and provide insights to enable a more nuanced discussion on the role of telemedicine in the care of PWOUD. Methods The literature search was conducted in OVID Medline, CINAHL, and PsycINFO, from inception up to and including April 2023, using the Joanna Briggs Institute methodology for scoping reviews. The review considered any study design that detailed sufficient descriptive information on a given TMOUD service. A data extraction form was developed to collect and categorize a range of descriptive characteristics of each discrete TMOUD model identified from the obtained articles. Results A total of 45 articles met the inclusion criteria, and from this, 40 discrete TMOUD services were identified. In total, 33 services were US-based, three from Canada, and one each from India, Ireland, the UK, and Norway. Through a detailed analysis of TMOUD service characteristics, four models of care were identified. These were TMOUD to facilitate inclusion health, to facilitate transitions in care, to meet complex healthcare needs, and to maintain opioid use disorder (OUD) service resilience. Conclusions Characterizing TMOUD according to its functional benefits to PWOUD and OUD services will help support evidence-based policy and practice. Additionally, particular attention is given to how digital exclusion of PWOUD can be mitigated against.

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Virtual Primary Care for People With Opioid Use Disorder: Scoping Review of Current Strategies, Benefits, and Challenges

Narayan,

Gooderham,

Spencer

et al. 2024

J Med Internet Res

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Background There is a pressing need to understand the implications of the rapid adoption of virtual primary care for people with opioid use disorder. Potential impacts, including disruptions to opiate agonist therapies, and the prospect of improved service accessibility remain underexplored. Objective This scoping review synthesized current literature on virtual primary care for people with opioid use disorder with a specific focus on benefits, challenges, and strategies. Methods We followed the Joanna Briggs Institute methodological approach for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist for reporting our findings. We conducted searches in MEDLINE, Web of Science, CINAHL Complete, and Embase using our developed search strategy with no date restrictions. We incorporated all study types that included the 3 concepts (ie, virtual care, primary care, and people with opioid use disorder). We excluded research on minors, asynchronous virtual modalities, and care not provided in a primary care setting. We used Covidence to screen and extract data, pulling information on study characteristics, health system features, patient outcomes, and challenges and benefits of virtual primary care. We conducted inductive content analysis and calculated descriptive statistics. We appraised the quality of the studies using the Quality Assessment With Diverse Studies tool and categorized the findings using the Consolidated Framework for Implementation Research. Results Our search identified 1474 studies. We removed 36.36% (536/1474) of these as duplicates, leaving 938 studies for title and abstract screening. After a double review process, we retained 3% (28/938) of the studies for extraction. Only 14% (4/28) of the studies were conducted before the COVID-19 pandemic, and most (15/28, 54%) used quantitative methodologies. We summarized objectives and results, finding that most studies (18/28, 64%) described virtual primary care delivered via phone rather than video and that many studies (16/28, 57%) reported changes in appointment modality. Through content analysis, we identified that policies and regulations could either facilitate (11/28, 39%) or impede (7/28, 25%) the provision of care virtually. In addition, clinicians’ perceptions of patient stability (5/28, 18%) and the heightened risks associated with virtual care (10/28, 36%) can serve as a barrier to offering virtual services. For people with opioid use disorder, increased health care accessibility was a noteworthy benefit (13/28, 46%) to the adoption of virtual visits, whereas issues regarding access to technology and digital literacy stood out as the most prominent challenge (12/28, 43%). Conclusions The available studies highlight the potential for enhancing accessibility and continuous access to care for people with opioid use disorder using virtual modalities. Future research and policies must focus on bridging gaps to ensure that virtual primary care does not exacerbate or entrench health inequities.

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Advancing virtual primary care for people with opioid use disorder (VPC OUD): a mixed-methods study protocol

Cited by 4 publications

References 49 publications

Virtual Primary Care for People with Opioid Use Disorder: A Scoping Review of Current Strategies, Benefits, and Challenges

Virtual Primary Care for People with Opioid Use Disorder: A Scoping Review of Current Strategies, Benefits, and Challenges

Understanding the use of telemedicine across different opioid use disorder treatment models: A scoping review

Virtual Primary Care for People With Opioid Use Disorder: Scoping Review of Current Strategies, Benefits, and Challenges

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