Referral of patients from rural primary care clinics to telemedicine vendors for opioid use disorder treatment: A mixed-methods study.

IF 3.2 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Journal of Telemedicine and Telecare Pub Date : 2025-07-01 Epub Date: 2024-01-22 DOI:10.1177/1357633X231226261
Chunqing Lin, Yuhui Zhu, Larissa J Mooney, Allison Ober, Sarah E Clingan, Laura-Mae Baldwin, Stacy Calhoun, Yih-Ing Hser
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引用次数: 0

Abstract

IntroductionRural primary care clinics can expand their medication treatment for opioid use disorder (MOUD) capacity by coordinating care with external telemedicine (TM) vendors specializing in addiction medicine. This study used mixed methods to identify factors that influence patient referrals from rural primary care clinics to TM vendors for MOUD.MethodsBetween July/August 2020 and January/February 2021, 582 patients with OUD were identified across six primary care sites; that included 68 referred to an external TM vendor to receive MOUD. Mixed effects logistic regression identified individual and site-level factors associated with being referred to the TM vendor. Clinic providers and staff participated in in-depth interviews and focus groups to discuss their considerations for referring patients to the TM vendor.ResultsPatient referrals were positively associated with local household broadband coverage (OR = 2.55, p < 0.001) and negatively associated with local population density (OR = 0.01, p  =  0.003) and the number of buprenorphine prescribers in the county (OR = 0.85, p < 0.001). Clinic personnel expressed appreciation for psychiatric expertise and the flexibility to access MOUD brought by the TM vendor. Perceived concerns about TM referral included a lack of trust with external providers, uncertainty about TM service quality, workflow delays, and patients' technological and insurance challenges.ConclusionThis study revealed several clinic-level factors that may potentially influence patient referral to TM vendor services for MOUD. To facilitate the referral process and utilization of TM vendors, efforts should be made to foster open communication and trust between clinic providers and TM vendors, streamline workflows, and improve Internet access for patients.

农村初级保健诊所向远程医疗供应商转诊阿片类药物使用障碍治疗患者:混合方法研究。
导言:农村初级保健诊所可通过与外部成瘾医学专业远程医疗(TM)供应商协调治疗,扩大其阿片类药物使用障碍(MOUD)的药物治疗能力。本研究采用混合方法来确定影响农村初级保健诊所向远程医疗供应商转介阿片类药物使用障碍(MOUD)患者的因素:在 2020 年 7 月/8 月至 2021 年 1 月/2 月期间,6 个初级医疗点共确定了 582 名 OUD 患者;其中包括 68 名转诊至外部 TM 供应商接受 MOUD 的患者。混合效应逻辑回归确定了与被转介到 TM 供应商相关的个人和医疗机构因素。诊所服务提供者和工作人员参加了深入访谈和焦点小组,讨论他们将患者转介给技术管理供应商的考虑因素:结果:病人转诊与当地家庭宽带覆盖率呈正相关(OR = 2.55,p 结论:病人转诊与当地家庭宽带覆盖率呈正相关(OR = 2.55,p 结论):本研究揭示了一些诊所层面的因素,这些因素可能会影响患者转诊至移动电话供应商处接受 MOUD 服务。为促进转诊过程和对 TM 供应商的利用,应努力促进诊所提供者与 TM 供应商之间的坦诚沟通和信任,简化工作流程,并改善患者的互联网访问。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
14.10
自引率
10.60%
发文量
174
审稿时长
6-12 weeks
期刊介绍: Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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