Meshberg-Cohen Sarah, Schnakenberg Martin Ashley M, Wolkowicz Noah R, Gross Georgina M, DeViva Jason C
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA.
Community Ment Health J. 2024 Dec 20. doi: 10.1007/s10597-024-01428-7.
This study examined treatment utilization across in-person and virtual treatment modalities in veterans who were on medications for opioid use disorder (MOUD; N = 139). Treatment records for veterans in addiction treatment on MOUD were examined for 3-months prior to telehealth conversions ("Pre-Telehealth," 12/02/2019-03/14/2020), 3-months during the initial telehealth transition ("Telehealth," 03/15/2020-06/30/2020) and 3-months during post-telehealth transition ("Re-Entry," 07/01/2020-10/01/2020). Analyses examined the relationship between treatment modality and demographic features, psychiatric comorbidities, treatment engagement, and illness severity as measured by psychiatric emergency room (PER) utilization. Results demonstrated that modality was not associated with PER utilization. Past-year PER visits, alcohol use disorder (AUD), and psychotic disorders were associated with PER utilization during Telehealth, while AUD was associated with Re-Entry PER utilization. Given the likelihood of virtual treatment in the future, frequent in-person visits may not be necessary for MOUD; however, individuals with comorbid AUD and psychotic disorders may need additional support to prevent emergency care.
本研究调查了正在使用阿片类物质使用障碍药物治疗（MOUD；N = 139）的退伍军人在面对面治疗和虚拟治疗模式下的治疗利用情况。对接受MOUD成瘾治疗的退伍军人在远程医疗转换前3个月（“远程医疗前”，2019年12月2日至2020年3月14日）、初始远程医疗过渡期间3个月（“远程医疗”，2020年3月15日至2020年6月30日）和远程医疗过渡后3个月（“重新进入”，2020年7月1日至2020年10月1日）的治疗记录进行了检查。分析考察了治疗模式与人口统计学特征、精神共病、治疗参与度以及通过精神科急诊室（PER）利用率衡量的疾病严重程度之间的关系。结果表明，治疗模式与PER利用率无关。过去一年的PER就诊、酒精使用障碍（AUD）和精神障碍与远程医疗期间的PER利用率相关，而AUD与重新进入期间的PER利用率相关。鉴于未来虚拟治疗的可能性，对于MOUD患者可能无需频繁进行面对面就诊；然而，患有AUD和精神障碍共病的个体可能需要额外的支持以预防急诊护理。
