A qualitative exploration of the use of telehealth for opioid treatment: Implications for nurse-managed care.
addiction
qualitative research
service delivery
telehealth
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
18 Mar 2024
18 Mar 2024
Historique:
revised:
25
02
2024
received:
23
08
2023
accepted:
11
03
2024
medline:
19
3
2024
pubmed:
19
3
2024
entrez:
19
3
2024
Statut:
aheadofprint
Résumé
To characterise experiences with telehealth for Medications for Opioid Use Disorder (MOUD) services among patients, prescribers, nurses and substance use counsellors to inform future best practices. We engaged a qualitative descriptive study design. Semi-structured interviews were conducted with prescribers (nurse practitioners and physicians, n = 20), nurses and substance use counsellors (n = 7), and patients (n = 20) between June and September 2021. Interviews were verbatim transcribed. Thematic analysis was conducted using a qualitative descriptive method. Among both providers and patients, four themes were identified: (1) Difficulties with telehealth connection (2) Flexibility in follow-up and retention, (3) Policy changes that enabled expanded care, (4) Path forward with telehealth. Two additional findings emerged from provider interviews: (1) Expansion of nurse-managed office-based opioid treatment, and (2) Novel methods to engage patients. Patients and providers continued to view telehealth as an acceptable means for delivery and management of MOUD, particularly when utilised in a hybrid manner between in-person visits. Nurse-managed care for this service was evident as nurses extended the breadth of services offered and utilised novel methods such as text messages and management of 'call-in' lines to engage patients. Use of telehealth for MOUD should be incorporated into practice settings to reach patients in a flexible manner. Nurses in particular can use this medium to extend office-based opioid treatment by conducting assessments and expanding capacity for other wrap-around services. We identify recommendations for best practices in the use of telehealth for opioid use disorder management and highlight the value of nurse-managed care. The consolidated criteria for reporting qualitative research. Patients with opioid use disorder and prescribers with experience using telehealth were interviewed for this study.
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : National Institutes of Health/National Center for Advancing Translational Sciences
ID : KL2TR002317
Organisme : Bloomberg American Health Initiative
Informations de copyright
© 2024 John Wiley & Sons Ltd.
Références
Alter, A., & Yeager, C. (2020). The consequences of COVID-19 on the overdose epidemic: Overdoses are increasing. Washington/Baltimore High Intensity Drug sTrafficking Area. Overdose Detection Mapping Application Program. https://www.odmap.org:4443/Content/docs/news/2020/ODMAP-Report-May-2020.pdf
ATLAS.ti Scientific Software Development GmbH. (2022). ATLAS.Ti 22 Windows. http://atlasti.com
Barsom, E. Z., Jansen, M., Tanis, P. J., van de Ven, A. W. H., Blussé van Oud-Alblas, M., Buskens, C. J., Bemelman, W. A., & Schijven, M. P. (2021). Video consultation during follow up care: Effect on quality of care and patient- and provider attitude in patients with colorectal cancer. Surgical Endoscopy, 35(3), 1278-1287. https://doi.org/10.1007/s00464-020-07499-3
Bateman, G., Tziggili, C., & Mirza, M. A. (2014). Psychopharmacological treatment of young people with substance dependence: A survey of prescribing practices in England. Child and Adolescent Mental Health, 19(2), 102-109.
Bradshaw, C., Atkinson, S., & Doody, O. (2017). Employing a qualitative description approach in health care research. Global qualitative. Nursing Research, 4. https://doi.org/10.1177/2333393617742282
Campbell, C. I., Saxon, A. J., Boudreau, D. M., Wartko, P. D., Bobb, J. F., Lee, A. K., Matthews, A. G., McCormack, J., Liu, D. S., Addis, M., Altschuler, A., Samet, J. H., LaBelle, C. T., Arnsten, J., Caldeiro, R. M., Borst, D. T., Stotts, A. L., Braciszewski, J. M., Szapocznik, J., … Bradley, K. A. (2021). PRimary care opioid use disorders treatment (PROUD) trial protocol: A pragmatic, cluster-randomized implementation trial in primary care for opioid use disorder treatment. Addiction Science & Clinical Practice, 16, 9. https://doi.org/10.1186/s13722-021-00218-w
Cantor, J., McBain, R. K., Kofner, A., Hanson, R., Stein, B. D., & Yu, H. (2022). Telehealth adoption by mental health and substance use disorder treatment facilities in the COVID-19 pandemic. Psychiatric Services (Washington, D.C.), 73(4), 411-417. https://doi.org/10.1176/appi.ps.202100191
Cos, T. A., Starbird, L. E., Lee, H., Chun, B., Gonnella, K., Bird, J., Livsey, K., Bastos, S., O'Brien, M., Clark, I., Jenkins, D., & Tavolaro-Ryley, L. (2021). Expanding access to nurse-managed medication for opioid use disorder. Nursing Outlook, 69(5), 848-855. https://doi.org/10.1016/j.outlook.2021.03.012
D'arrigo, T. (2023). APA Responds to DEA's Proposed Rules Regarding Telehealth, Buprenorphine. Psychiatry Online. https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2023.05.5.47
Drug Enforcement Administration. (2020). Letter to DEA Qualifying Practitioners. https://www.samhsa.gov/sites/default/files/dea-samhsa-buprenorphine-telemedicine.pdf?mc_cid=8dffbfc637&mc_eid=d4494a732e.
Farley, J. E., Kelly, A. M., Reiser, K., Brown, M., Kub, J., Davis, J. G., Walshe, L., & Van der Walt, M. (2014). Development and evaluation of a pilot nurse case management model to address multidrug-resistant tuberculosis (MDR-TB) and HIV in South Africa. PLoS ONE, 9(11), e111702. https://doi.org/10.1371/journal.pone.0111702
Federal Register. (2023). Expansion of Induction of Buprenorphine via Telemedicine Encounter. 88 FR 12890. https://www.federalregister.gov/documents/2023/03/01/2023-04217/expansion-of-induction-of-buprenorphine-via-telemedicine-encounter
Guilamo-Ramos, V., Thimm-Kaiser, M., Benzekri, A., Hidalgo, A., Lanier, Y., Tlou, S., de Lourdes Rosas López, M., Soletti, A. B., & Hagan, H. (2021). Nurses at the frontline of public health emergency preparedness and response: Lessons learned from the HIV/AIDS pandemic and emerging infectious disease outbreaks. The Lancet. Infectious Diseases, 21(10), e326-e333. https://doi.org/10.1016/S1473-3099(20)30983-X
Hulsey, J., Mellis, A., & Kelly, B. (2020). COVID-19 pandemic impact on patients, families and individuals in recovery from substance use disorder. Addiction Policy Forum. https://www.addictionpolicy.org/covid19-report
Inslee, J. (2020). Substitute Senate Bill 6061: Telemedicine-Training Standards. https://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Session%20Laws/Senate/6061-S.SL.pdf?q=20201202110138
LaBelle, C. T., Han, S. C., Bergeron, A., & Samet, J. H. (2016). Office-based opioid treatment with buprenorphine (OBOT-B): Statewide implementation of the Massachusetts collaborative care model in community health centers. Journal of Substance Abuse Treatment, 60, 6-13. https://doi.org/10.1016/j.jsat.2015.06.010
Larochelle, M. R., Bernson, D., Land, T., Stopka, T. J., Wang, N., Xuan, Z., Bagley, S. M., Liebschutz, J. M., & Walley, A. Y. (2018). Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: A cohort study. Annals of Internal Medicine, 169(3), 137-145. https://doi.org/10.7326/M17-3107
Lee, J. D., Grossman, E., DiRocco, D., & Gourevitch, M. N. (2009). Home buprenorphine/naloxone induction in primary care. Journal of General Internal Medicine, 24(2), 226-232. https://doi.org/10.1007/s11606-008-0866-8
Mahmoud, H., Naal, H., Whaibeh, E., & Smith, A. (2022). Telehealth-based delivery of medication-assisted treatment for opioid use disorder: A critical review of recent developments. Current Psychiatry Reports, 24, 1-12.
Mancher, M., Leshner, A. I., & National Academies of Sciences, Engineering, and Medicine. (2019). The effectiveness of medication-based treatment for opioid use disorder. In Medications for opioid use disorder save lives. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK541393/
Maryland Public Service Commissions. (2024). Lifeline Availability in Maryland. https://www.psc.state.md.us/telecommunications/lifeline-availability-maryland/
Platt, L., Minozzi, S., Reed, J., Vickerman, P., Hagan, H., French, C., Jordan, A., Degenhardt, L., Hope, V., Hutchinson, S., Maher, L., Palmateer, N., Taylor, A., Bruneau, J., & Hickman, M. (2017). Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs. The. Cochrane Database of Systematic Reviews, 9(9), CD012021. https://doi.org/10.1002/14651858.CD012021.pub2
Ranjit, Y. S., Davis, W. M., Fentem, A., Riordan, R., Roscoe, R., & Cavazos-Rehg, P. (2023). Text messages exchanged between individuals with opioid use disorder and their mHealth e-coaches: Content analysis study. JMIR Human Factors, 10(1), e37351. https://doi.org/10.2196/37351
Seidman, G., & Atun, R. (2017). Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Human Resources for Health, 15(1), 29. https://doi.org/10.1186/s12960-017-0200-9
Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J., & Smith, A. C. (2021). The clinical effectiveness of telehealth: A systematic review of meta-analyses from 2010 to 2019. Journal of Telemedicine and Telecare, 1357633X211022907. https://pubmed.ncbi.nlm.nih.gov/34184580/
Spetz, J., Hailer, L., Gay, C., Tierney, M., Schmidt, L. A., Phoenix, B., & Chapman, S. A. (2022). Buprenorphine treatment: Advanced practice nurses add capacity. Health Affairs (Project Hope), 41(9), 1231-1237. https://doi.org/10.1377/hlthaff.2022.00310
Substance Abuse and Mental Health Services Administration. (2020). Opioid Treatment Program (OTP) Guidance. https://www.samhsa.gov/sites/default/files/otp-guidance-20200316.pdf
Substance Abuse and Mental Health Services Administration. (2023). DEA, SAMHSA Extend COVID-19 Telemedicine Flexibilities for Prescribing Controlled Medications for Six Months While Considering Comments from the Public. https://www.samhsa.gov/newsroom/press-announcements/20230509/dea-extend-covid19-telemedicine-flexibilities-prescribing-controlled-medications
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. https://doi.org/10.1093/intqhc/mzm042
World Health Organization. (2021). Opioid overdose. https://www.who.int/news-room/fact-sheets/detail/opioid-overdose#:~:text=Worldwide%2C%20about%20500%20000%20deaths,those%20deaths%20caused%20by%20overdose