Telemedicine-delivered treatment interventions for substance use disorders: A systematic review

Lin, Lewei Allison; Casteel, Danielle; Shigekawa, Erin; Weyrich, Meghan S; Roby, Dylan H.; McMenamin, Sara B.

doi:10.1016/j.jsat.2019.03.007

Cited by 222 publications

(228 citation statements)

References 35 publications

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“…In a review of 46 telehealth interventions for serious mental illness populations, Naslund et al (2015) found high feasibility and tolerability among patients with schizophrenia, schizoaffective disorder, or bipolar disorder. Additionally, good telehealth utilization was observed in populations with schizophrenia (Santesteban-Echarri, Piskulic, Nyman, & Addington, 2020), substance use disorders (Lin et al, 2019), PTSD (Turgoose, Ashwick, & Murphy, 2017).…”

Section: Discussionmentioning

confidence: 99%

Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement

Miu

Palka

et al. 2020

Counselling Psychology Quarterly

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The COVID-19 pandemic completely changed daily lives and psychotherapy clinical operations. Treatment engagement with serious mental illness (SMI) populations is inherently challenging. COVID-19 may pose more challenges to treatment engagement with SMI populations due to the rapid change to telehealth and exacerbation of symptoms. SMI patients may be less likely to convert to telehealth or stay engaged in treatment compared to non-SMI patients during COVID-19. Nevertheless, treatment engagement via teletherapy is vital to supporting the vulnerable SMI populations during this stressful pandemic. In this study, we compared teletherapy conversion and utilization rates between SMI and general populations in an outpatient psychiatric clinic (n = 816) during COVID-19. We found no differences in telehealth conversion for patients with SMI (52%) and non-SMI (48%), suggesting equivalent adoption of teletherapy among SMI and non-SMI populations. Beyond conversion, we found that the SMI group had a significantly greater number of teletherapy visits compared to non-SMI patients, indicating that SMI group utilized teletherapy regularly after conversion. There were no group differences in new patients beginning therapy via telehealth, which shows that the SMI group was not more deterred to seek help. Our findings inform the feasibility of telehealth for serious mental illness populations during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement

Miu

Palka

et al. 2020

Counselling Psychology Quarterly

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“…Medications to manage withdrawal, reduce cravings and prevent relapse on alcohol may be less available as some providers may not be comfortable prescribing these in an outpatient setting or via telemedicine. 49 However, for management of alcohol withdrawal, outpatient/telemedicine prescribing is feasible since most elite athletes have good general health and therefore are less likely to experience severe withdrawal (eg, seizures, delirium tremens) or serious medical complications (eg, alcohol-related hepatitis). Withdrawal can be managed using standard fixed-schedule or symptom-triggered protocols with benzodiazepines such as diazepam, lorazepam or chlorodiazepoxide.…”

Section: Reviewmentioning

confidence: 99%

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Bindra²,

et al. 2020

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Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.

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“…While primary care was one of the first medical specialities to adapt to its use to manage COVID-19, a number of other specialities have reported on the use of novel remote models of care at this time [14,15,19]. Historically, OAT services have successfully used telemedicine for hepatitis C treatment and providing psychological and other supports [16][17][18]24]. Mental health services have also demonstrated success with remote care [19].…”

Section: Discussionmentioning

confidence: 99%

“…Historically, a small number of OAT services have successfully used telemedicine for hepatitis c treatment and providing psychological and other supports [16][17][18]. Mental health services have also demonstrated success with remote care and of course general practice was one of the first medical specialities to adapt to its use to manage COVID-19 [14,19].…”

Section: Model Developmentmentioning

confidence: 99%

A national model of remote care for assessing and providing opioid agonist treatment during the COVID-19 pandemic: a report

Crowley

Delargy²

2020

Harm Reduct J

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Background: Health services globally are struggling to manage the impact of COVID-19. The existing global disease burden related to opioid use is significant. Particularly challenging groups include older drug users who are more vulnerable to the effects of COVID-19. Increasing access to safe and effective opioid agonist treatment (OAT) and other harm reduction services during this pandemic is critical to reduce risk. In response to COVID-19, healthcare is increasingly being delivered by telephone and video consultation, and this report describes the development of a national model of remote care to eliminate waiting lists and increase access to OAT in Ireland. Purpose and findings: The purpose of this initiative is to provide easy access to OAT by developing a model of remote assessment and ongoing care and eliminate existing national waiting lists. The Irish College of General Practitioners in conjunction with the National Health Service Executive office for Social Inclusion agreed a set of protocols to enable a system of remote consultation but still delivering OAT locally to people who use drugs. This model was targeted at OAT services with existing waiting lists due to a shortage of specialist medical staff. The model involves an initial telephone assessment with COVID-risk triage, a single-patient visit to local services to provide a point of care drug screen and complete necessary documentation and remote video assessment and ongoing management by a GP addiction specialist. A secure national electronic health link system allows for the safe and timely delivery of scripts to a designated local community pharmacy. Conclusion: The development of a remote model of healthcare delivery allows for the reduction in transmission risks associated with COVID-19, increases access to OAT, reduces waiting times and minimises barriers to services. An evaluation of this model is ongoing and will be reported once completed. Fast adaptation of OAT delivery is critical to ensure access to and continuity of service delivery and minimise risk to our staff, patients and community. Innovative models of remote healthcare delivery adapted during the COVID-19 crisis may inform and have important benefits to our health system into the future.

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Telemedicine-delivered treatment interventions for substance use disorders: A systematic review

Cited by 222 publications

References 35 publications

Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement

Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

A national model of remote care for assessing and providing opioid agonist treatment during the COVID-19 pandemic: a report

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