November 18, 2024

People with opioid use disorder (OUD) who started treatment with a long-acting opioid agonist and telehealth only appointments were 61% less likely to discontinue treatment than a comparison group who received office-based treatment as usual. Among the telehealth-only group, 4% discontinued treatment at some point during 24 weeks of treatment, compared to a 13% discontinuation rate among those who received treatment as usual. 

The study took place in Oregon and Washington from September 2021 through March 2023. The telehealth-only intervention took place via a mobile application that facilitated secure audio, video, and chat with an interdisciplinary care team that included a prescribing clinical professional, a care advocate, and a peer recovery specialist. The care advocates helped the participants navigate the broader health care system (such as pharmacies and insurance) to overcome access gaps, discontinuity, and stigma. The peer recovery specialists provided peer-based recovery support focused on improving overall health and well-being and quality of life. 

Prospective participants enrolled in telehealth treatment either via telephone or a web-based form with a goal of a long-acting opioid agonist prescription within 48 hours. Those without video access received audio-only care via a telephone. The program facilitated participant acquisition of a subsidized smartphone and internet access. 

These findings were reported in “Buprenorphine Discontinuation In Telehealth-Only Treatment For Opioid Use Disorder: A Longitudinal Cohort Analysis” by Brian Chan, Ryan Cook, Ximena Levander, and colleagues. The researchers conducted a longitudinal observational cohort study from September 2021 through March 2023 in Oregon and Washington. In total, the study enrolled 159 people with opioid use disorder (OUD) who were treated with a long-acting opioid agonist; 103 received fully remote, telehealth-only treatment, and 56 received office-based treatment as usual. The researchers followed the participants’ medication discontinuation rates over 24 weeks. About 83% of the participants were enrolled in Medicaid. About 65% were unemployed, and 19% were unhoused. 

The full text of “Buprenorphine Discontinuation In Telehealth-Only Treatment For Opioid Use Disorder: A Longitudinal Cohort Analysis” was published in the December 2024 issue of Journal of Substance Use and Addiction Treatment.