Among Veterans Health Administration patients receiving buprenorphine for opioid use disorder (OUD), telehealth is associated with increased retention for both new and continuing patients, according to a study published in JAMA Network Open. Madeline C. Frost, PhD, and colleagues compared patient characteristics across receipt of different
treatment modalities (in-person vs telehealth; video vs telephone) for buprenorphine delivery to assess whether modality was associated with retention during the year following COVID-19-related policy changes. The analysis included 17,182 patients receiving buprenorphine for OUD. Patients who were younger, male, Black, Hispanic, or nonservice-connected or had specific mental health/ substance use comorbidities were less likely to receive any telehealth. Telehealth patients who were older, male, Black, non-service-connected, or experiencing homelessness and/or housing instability were less likely to have video visits. Compared with only in-person visits, retention was significantly higher for patients with telehealth regardless of initiation time (initiation in the year following COVID-19-related changes: adjusted OR [aOR], 1.31; initiation prior to COVID-19-related changes: aOR, 1.23). Among telehealth patients who initiated in the year following COVID-19, higher retention was seen for those with video visits versus only telephone (aOR, 1.47). “These findings suggest that discontinuing or reducing telephone access may disrupt treatment for many patients, particularly groups with access disparities such as Black patients and those experiencing homelessness,” Dr. Frost and colleagues wrote.