Department of Health Care Policy, Harvard Medical School, 180A Longwood Avenue, Boston, MA, 02115, USA.
RAND Corporation, Arlington, VA, USA.
J Gen Intern Med. 2022 Jan;37(1):162-167. doi: 10.1007/s11606-021-07174-w. Epub 2021 Oct 28.
The Ryan Haight Act generally requires a clinician to conduct an in-person visit before prescribing an opioid use disorder (OUD) medication. This requirement has impeded use of telemedicine to expand OUD treatment, and many policymakers have called for its removal. During the COVID-19 pandemic, beginning March 16, 2020, the requirement was temporarily waived. It is unclear whether clinicians who treat OUD patients perceive telemedicine to be a safe and effective means of OUD medication initiation.
To understand clinician use of and comfort level with using telemedicine to initiate patients on medication for opioid use disorder.
National survey administered electronically via WebMD/Medscape's online clinician panel in fall 2020.
A total of 602 clinicians (primary care providers, psychiatrists, nurse practitioners or certified nurse specialists, and physician assistants) participated in the survey.
Frequency of video, audio-only, and in-person visits for medication initiation, comfort level with using video for new patient visits with OUD.
Clinicians varied substantially in their use of telemedicine for medication initiation. Approximately 25% used telemedicine for most initiations while 40% used only in-person visits. The majority (55.8%) expressed at least some discomfort with using telemedicine for treating new OUD patients, although clinicians with more OUD patients were less likely to express such discomfort.
Findings suggest that a permanent relaxation of the Ryan Haight requirement may not result in widespread adoption of telemedicine for OUD medication initiation without additional supports or incentives.
瑞安·海特法案通常要求临床医生在开出阿片类药物使用障碍（OUD）药物之前进行面对面就诊。这一要求阻碍了远程医疗在扩大 OUD 治疗中的应用，许多政策制定者呼吁取消这一要求。在 COVID-19 大流行期间，从 2020 年 3 月 16 日开始，该要求暂时被豁免。目前尚不清楚治疗 OUD 患者的临床医生是否认为远程医疗是启动 OUD 药物治疗的一种安全有效的方法。
了解临床医生使用远程医疗启动 OUD 患者药物治疗的情况和对其的舒适度。
2020 年秋季通过 WebMD/Medscape 的在线临床医生小组以电子方式进行的全国性调查。
共有 602 名临床医生（初级保健提供者、精神科医生、执业护士或注册护士专家以及医师助理）参与了这项调查。
用于启动药物治疗的视频、音频和面对面就诊的频率，以及使用视频为新 OUD 患者就诊的舒适度。
临床医生在使用远程医疗启动药物治疗方面存在很大差异。大约 25%的人主要使用远程医疗进行启动，而 40%的人仅使用面对面就诊。大多数（55.8%）表示在使用远程医疗治疗新的 OUD 患者时至少有些不适，尽管治疗 OUD 患者较多的临床医生不太可能表达这种不适。
研究结果表明，如果没有额外的支持或激励措施，瑞安·海特法案要求的永久放宽可能不会导致远程医疗在 OUD 药物启动方面得到广泛采用。
