Journal article
The Association Between Telehealth Use During Buprenorphine Treatment for Opioid Use Disorder and Clinical Outcomes: A Retrospective Cohort Study
Telemedicine journal and e-health, Vol.31(3), 0410
03/03/2025
DOI: 10.1089/tmj.2024.0410
PMID: 39582440
Abstract
Background: Patients with opioid use disorder (OUD) represent a high-risk population due to increased rates of adverse health outcomes and death. To evaluate whether telehealth utilization during OUD treatment compared with in-person encounters alone was associated with emergency department (ED) utilization, inpatient admissions, and mortality within three years of initiating buprenorphine. Methods: We conducted a retrospective cohort study within the Veterans Health Administration among Veterans treated for OUD between 2012 and -2022. The primary exposure was modality of care, characterized as telehealth encounters (with or without an in-person visit) compared with in-person visits only. Outcomes included an ED visit, inpatient admission, or mortality within three years of the index buprenorphine prescription. We measured the association between each type of treatment modality and outcomes through Cox proportional hazards regression modeling, adjusting for demographic and clinical covariates and confounders. Findings: Of the 57,021 Veterans diagnosed with OUD and who initiated buprenorphine, 38,072 Veterans met study eligibility criteria. The majority of Veterans were male, non-Hispanic White, 25-44 years of age, and lived in urban areas. Approximately 60% of this entire cohort experienced at least one ED visit, 40% experienced an inpatient admission, and 8% died during follow-up. Telehealth use compared with in-person visits only was associated with reduced ED visits (adjusted hazard ratio [aHR] 0.81; 95% confidence interval [CI] 0.77-0.85), inpatient admissions (aHR: 0.71; 95% CI: 0.67-0.76), and mortality (aHR: 0.80; 95% CI: 0.67-0.94). Conclusions: Telehealth may help overcome barriers to in-person care. During buprenorphine treatment for OUD, telehealth as a point of contact with providers and the health care system may reduce more adverse health outcomes, potentially through improving treatment retention. Qualitative studies may help shed light on the mechanisms through which telehealth directly impacts clinical outcomes.
Details
- Title: Subtitle
- The Association Between Telehealth Use During Buprenorphine Treatment for Opioid Use Disorder and Clinical Outcomes: A Retrospective Cohort Study
- Creators
- J. Priyanka Vakkalanka - University of IowaBrian C. Lund - University of IowaStephan Arndt - University of IowaKnute D. Carter - University of IowaRyan Carnahan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.31(3), 0410
- DOI
- 10.1089/tmj.2024.0410
- PMID
- 39582440
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Publisher
- MARY ANN LIEBERT, INC
- Grant note
- Office for the Advancement of Telehealth, Health Resources and Services Administration: U3GRH40003
This study was supported by funding from the Office for the Advancement of Telehealth, Health Resources and Services Administration (U3GRH40003).
- Language
- English
- Electronic publication date
- 11/25/2024
- Date published
- 03/03/2025
- Academic Unit
- Rural Telehealth Research Center; Psychiatry; Epidemiology; Emergency Medicine; Biostatistics; Nursing; Injury Prevention Research Center
- Record Identifier
- 9984750659502771
Metrics
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