First Published in Psychiatric News Alert
The number of individuals prescribed buprenorphine for opioid use disorder (OUD) during the first year of the COVID-19 pandemic increased steadily after the federal government instituted policies that allowed for greater use of telehealth, according to a report in AJP in Advance.
“The majority of visits shifted to telehealth, with telephone visits outnumbering video visits,” wrote Lewei (Allison) Lin, M.D., M.S., of the University of Michigan Addiction Center, and colleagues.
Key policy changes, implemented in March 2020, expanded telehealth access for patients; for example, patients were no longer required to travel to a qualifying “originating site” for telehealth encounters, regardless of geographic location. Later, the government allowed permanent payment for audio-only telehealth encounters.
Lin and colleagues used data from the Veterans Health Administration (VHA) to compare trends in buprenorphine treatment before and after the COVID-19 policy changes were implemented in March 2020. They compared the number of patients receiving buprenorphine from March 2019 to February 2020 (before policy changes) with those receiving buprenorphine from March 2020 to February 2021 (after policy changes).
The main outcome was the monthly number of patients receiving buprenorphine treatment for OUD (at least one day that month). They also examined the number of patients continuing buprenorphine treatment (defined as those who received any buprenorphine in the previous three months) and the number of patients who started treatment (defined as those with no buprenorphine fills covering any days in the previous three months).
The number of VHA patients receiving buprenorphine for OUD increased 14% from 13,415 in March 2019 to 15,339 in February 2021. Between March 2019 and February 2020, the number of patients receiving buprenorphine increased significantly by 103 patients per month. In the first month after the COVID-19 policy changes, there was an immediate increase of 265 patients receiving buprenorphine, the authors noted, and this number continued to increase by 47 patients per month.
The number of patients continuing buprenorphine treatment increased at a rate of 107 per month between March 2019 and February 2020, and the rate continued to increase at 53 patients per month after the policy changes. The number of patients who started treatment decreased overall across both periods, but the rate of decrease was not statistically significant.
“[B]uprenorphine treatment for OUD was maintained during the COVID-19 pandemic through a rapid shift to telehealth, suggesting that any future changes to telehealth policies must be carefully considered, as they could have major implications for patient care,” the authors wrote.
Paper Cited: Lin, L., Zhang, L., Kim, H. M., & Frost, M. C. (2022). Impact of COVID-19 Telehealth Policy Changes on Buprenorphine Treatment for Opioid Use Disorder. American Journal of Psychiatry, appi: ajp.https://doi.org/10.1176/appi.ajp.21111141.