A Telemedicine Buprenorphine Clinic to Serve New York City: Initial Evaluation of the NYC Public Hospital System's Initiative to Expand Treatment Access During the COVID-19 Pandemic.

Szczegóły
Abstrakt

Tytuł:: A Telemedicine Buprenorphine Clinic to Serve New York City: Initial Evaluation of the NYC Public Hospital System's Initiative to Expand Treatment Access During the COVID-19 Pandemic.
Autorzy:: Tofighi B; Department of Population Health, New York University School of Medicine, New York, NY (BT, JM, DW, KF, CSC, IS, DS, NK); Division of General Internal Medicine, Bellevue Hospital Center, New York, NY (BT, JM, DS); Center for Drug Use and HIV Research, New York, NY (BT, JM, NK); NYC Health+Hospitals, New York, NY (DS); Department of Psychiatry, New York University School of Medicine, New York, NY (AD); Department of Psychiatry, Bellevue Hospital Center, New York, NY (DW, KF, AD, CSC, IS, TR).
McNeely J
Walzer D
Fansiwala K
Demner A
Chaudhury CS
Subudhi I
Schatz D
Reed T
Krawczyk N
Źródło:: Journal of addiction medicine [J Addict Med] 2022 Jan-Feb 01; Vol. 16 (1), pp. e40-e43.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: [Alphen aan den Rijn, the Netherlands] : Wolters Kluwer Health, Inc.
Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins
MeSH Terms:: Buprenorphine*/therapeutic use
COVID-19*
Opioid-Related Disorders*/drug therapy
Opioid-Related Disorders*/epidemiology
Telemedicine*
Adult ; Hospitals, Public ; Humans ; Narcotic Antagonists/therapeutic use ; New York City/epidemiology ; Opiate Substitution Treatment ; Pandemics ; Retrospective Studies ; SARS-CoV-2
References:: Becker WC, Fiellin DA. When epidemics collide: Coronavirus disease 2019 (COVID-19) and the opioid crisis. Ann Intern Med 2020; 173:59–60.
Alexander GC, Stoller KB, Haffajee RL, Saloner B. An epidemic in the midst of a pandemic: opioid use disorder and COVID-19. Ann Intern Med 2020; 173 (1):57–58.
Weintraub E, Greenblatt AD, Chang J, Himelhoch S, Welsh C. Expanding access to buprenorphine treatment in rural areas with the use of telemedicine. Am J Addict 2018; 27:612–617.
Zheng W, Nickasch M, Lander L, et al. Treatment outcome comparison between telepsychiatry and face-to-face buprenorphine medication-assisted treatment for opioid use disorder: a 2-year retrospective data analysis. J Addict Med 2017; 11:138–144.
Eibl JK, Gauthier G, Pellegrini D, et al. The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting. Drug Alcohol Depend 2017; 176:133–138.
Gilmore AK, Wilson SM, Skopp NA, Osenbach JE, Reger G. A systematic review of technology-based interventions for co-occurring substance use and trauma symptoms. J Telemed Telecare 2017; 23:701–709.
Bhatraju EP, Grossman E, Tofighi B, et al. Public sector low threshold office-based buprenorphine treatment: outcomes at year 7. Addict Sci Clin Pract 2017; 12 (1):7.
Lee JD, Grossman E, DiRocco D, Gourevitch MN. Home buprenorphine/naloxone induction in primary care. J Gen Intern Med 2009; 24 (2):226–232. 22. McKellar J, Wagner T, Harris A, Oehlert M, Buckley S, Moos R. One-year outcomes of telephone case monitoring for patients with substance use disorder. Addict Behav 2012;37:1069-74.
Tofighi B, Williams AR, Chemi C, Suhail-Sindhu S, Dickson V, Lee JD. Patient barriers and facilitators to medications for opioid use disorder in primary care. Subst Use Misuse 2019; 54 (14):2409–2419.
Grant Information:: K23 DA042140 United States DA NIDA NIH HHS
Substance Nomenclature:: 0 (Narcotic Antagonists)
40D3SCR4GZ (Buprenorphine)
Entry Date(s):: Date Created: 20210209 Date Completed: 20220209 Latest Revision: 20230718
Update Code:: 20240104
PubMed Central ID:: PMC8339146
DOI:: 10.1097/ADM.0000000000000809
PMID:: 33560696
: Czasopismo naukowe

Objectives: The purpose of this study was to assess the feasibility and clinical impact of telemedicine-based opioid treatment with buprenorphine-naloxone following the Coronavirus disease 2019 pandemic.
Methods: Participants included in this retrospective analysis consisted of adult New York City residents with opioid use disorder eligible for enrollment in the NYC Health+Hospitals Virtual Buprenorphine Clinic between March and May 2020 (n = 78). Follow-up data were comprised of rates of retention in treatment at 2 months, referrals to community treatment, and induction-related events.
Results: During the initial 9 weeks of clinic operations, the clinic inducted 78 patients on to buprenorphine-naloxone and completed 252 visits. Patient referrals included non-NYC Health + Hospitals (n = 22, 28.2%) and NYC Health + Hospitals healthcare providers (n = 17, 21.8%), homeless shelter staff (n = 13, 16.7%), and the NYC Health + Hospitals jail reentry program in Rikers Island (n = 11, 14.1%). At 8 weeks, 42 patients remained in care (53.8%), 21 were referred to a community treatment program (26.9%), and 15 were lost to follow-up (19.2%). No patients were terminated from care due to disruptive behavior or suspicions of diversion or misuse of Buprenorphine. Adverse clinical outcomes were uncommon and included persistent withdrawal symptoms (n = 8, 4.3%) and one nonfatal opioid overdose (0.5%).
Conclusions: Telemedicine-based opioid treatment and unobserved home induction on buprenorphine-naloxone offers a safe and feasible approach to expand the reach of opioid use disorder treatment, primary care, and behavioral health for a highly vulnerable urban population during an unprecedented natural disaster.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2021 American Society of Addiction Medicine.)

Informacja