From the RAND Corporation, Boston, MA (JLS); Greater Los Angeles VA Medical Center, Los Angeles, CA (PR); Harvard Medical School, Boston, MA (HAH, AM, ABB); Beth Israel Deaconess Medical Center, Boston, MA (AM); McLean Hospital, Belmont, MA (ABB); Harvard T. H. Chan School of Public Health, Boston, MA (MLB); RAND Corporation, Arlington, VA (LU-P).
J Addict Med. 2022;16(6):702-708. doi: 10.1097/ADM.0000000000001006. Epub 2022 Jul 20.
Telemedicine for opioid use disorder (tele-OUD) has the potential to increase access to medications for OUD (MOUD). Fully virtual tele-OUD services, in which all care is provided via telemedicine, are increasingly common, yet few studies document the experiences of patients who use such services. Understanding patient perspectives is one of multiple considerations to inform the regulation and reimbursement of tele-OUD services.
We conducted semi-structured interviews with 20 adults receiving care from one fully virtual tele-OUD service who had received 3 to 5 weeks of treatment. Analyses were conducted using an inductive and deductive approach informed by the modified Unified Theory of Acceptance and Use of Technology model.
Over three quarters of patients with past experience receiving in-person MOUD treatment described tele-OUD as more advantageous with its key strength being more patient centered. Over three quarters of patients said they felt tele-OUD helped to ameliorate social barriers to seeking treatment, and nearly all said they appreciated the speed at which they were able to initiate MOUD treatment via tele-OUD. Surprisingly, the pandemic was not among the factors that influenced patient interest in tele-OUD.
Patients engaged in one fully virtual tele-OUD service described unique advantages of tele-OUD. More research is needed to determine the appropriateness of tele-OUD for people in various stages of recovery, and data on long-term treatment outcomes are needed to inform decisions regarding the regulation and reimbursement of fully virtual and hybrid care models for OUD.
远程医疗治疗阿片类药物使用障碍（远程 OUD）有可能增加获得 OUD 药物治疗（MOUD）的机会。完全虚拟的远程 OUD 服务，即所有护理均通过远程医疗提供，越来越常见，但很少有研究记录使用此类服务的患者的体验。了解患者的观点是为远程 OUD 服务提供监管和报销提供信息的多个考虑因素之一。
我们对 20 名正在接受一家完全虚拟的远程 OUD 服务的成年人进行了半结构化访谈，这些患者接受了 3 至 5 周的治疗。分析采用了基于修正的统一技术接受和使用理论的归纳和演绎方法。
超过四分之三有过接受面对面 MOUD 治疗经历的患者表示，远程 OUD 更具优势，其主要优势在于更以患者为中心。超过四分之三的患者表示，他们认为远程 OUD 有助于缓解寻求治疗的社会障碍，几乎所有人都表示他们赞赏通过远程 OUD 能够如此迅速地开始 MOUD 治疗。令人惊讶的是，大流行并不是影响患者对远程 OUD 兴趣的因素之一。
参与一家完全虚拟的远程 OUD 服务的患者描述了远程 OUD 的独特优势。需要进一步研究以确定远程 OUD 对于处于不同康复阶段的人群是否合适，并且需要关于长期治疗结果的数据，以告知有关 OUD 的完全虚拟和混合护理模式的监管和报销决策。
