Experiences of Opioid Use Disorder Patients Receiving Buprenorphine Through a Telehealth Program

Abstract

Background Opioid use disorder (OUD) continues to be a growing and major public health issue in the United States. In an effort to increase OUD treatment access, medication-assisted treatment with buprenorphine via telehealth is emerging as the leading treatment option. Objective This study sought to describe the experiences of adults with OUD receiving medication-assisted treatment buprenorphine in a nurse-practitioner-facilitated telehealth program. Methods Using a descriptive qualitative design, convenience sampling was used to recruit participants who were currently receiving OUD treatment in one telehealth program with locations in California and Michigan. Participants were invited to participate in the study via an email flyer sent to all clients of the telehealth program. Participants completed demographic data and took part in individual, semistructured interviews that were conducted online. Results The study sample included 15 largely White, married, college-educated men (n = 8, 53%) and women (n = 7, 47%). Qualitative content analysis of interview data revealed three overall themes and associated subthemes: (a) improved access to care, (b) isolation, and (c) feeling normal on buprenorphine. Conclusion Our findings support a nurse-practitioner-facilitated telehealth treatment program for OUD. However, in a program that offers patient-centered care that does not have a one-size-fits-all approach to service, goals of care must be reevaluated throughout treatment. Moreover, given the increased risk of patients feeling isolated with telehealth appointments and the lack of physical face-to-face interactions, healthcare providers should explore ways to engage patients in meaningful support resources and reduce stigma.

Telehealth-Based Delivery of Medication-Assisted Treatment for Opioid Use Disorder: a Critical Review of Recent Developments

“…Almost all studies were published between 2020 and 2022, with the exception of two published in 2018 and 2019. Most commonly, studies employed a retrospective design ( n = 10) [ 8 , 12 , 22 – 29 ], a qualitative design ( n = 7) [ 10 , 30 31 , 32 •, 33 – 35 ], or a case study design ( n = 6) [ 36 – 40 , 41 •]. The rest followed a mixed-methods approach ( n = 2) [ 16 , 42 ], a prospective cohort design ( n = 1) [ 43 ], non-randomized control trial ( n = 1) [ 44 ], cross-sectional design ( n = 1) [ 45 ], or a commentary approach narrating experience ( n = 2) [ 46 , 47 ].…”

“…Seeing the publication time period, perhaps the most reported non-clinical outcomes related to improving access to care in the context of mobility restrictions, especially among hard to reach and rural populations. For instance, some authors reported improved outreach with vulnerable patients, reduced wait times, and improved access to treatment upon transitioning to tele-MOUD [ 10 , 23 , 25 , 37 , 40 ]. Authors attributed these findings to the ability of tele-MOUD to bypass issues such as childcare, work commitments, transportation challenges, stigma, and increased flexibility in scheduling.…”

“…Medication-assisted therapy (MAT) refers to the use of medications such as opioid agonists (methadone), antagonists (naltrexone), or partial agonists (buprenorphine or buprenorphine/naloxone), to treat OUD [ 9 ]. MAT is considered the gold standard for treating OUD, with consistently demonstrated superior clinical outcomes compared to abstinence-based approaches [ 10 ]. MAT mitigates withdrawal symptoms, limits cravings, and blocks some of the euphoric and sedating effects of opioids [ 9 , 11 ].…”

“…TBH is defined as the use of information and communication technologies, such as videoconferencing, to deliver behavioral health services remotely. TBH has received widespread support with regard to its effectiveness, efficiency, utility, and feasibility, and has demonstrated comparable clinical outcomes to in-person treatment in behavioral health [ 10 ].…”

The impact of COVID-19 on health care professionals who are exposed to drug-related deaths while supporting clients experiencing addiction

“…Research on new working practices emerged at the time of this study, so it is difficult to draw conclusions about how different cohorts adjusted. Similar to the participants in the current study, some have argued that telehealth provision has facilitated easier access to services ( Molfenter et al, 2021 ), and others are concerned that particular cohorts have struggled with access to technology and isolation ( Moore et al, 2021 ). Limited data exist from the service users' perspective.…”