Primary Care Providers' Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic.

IF 3 Q1 PRIMARY HEALTH CARE
Sarah Alexandra Marshall, Lachan E Siebenmorgen, Katherine Youngen, Tyrone Borders, Nickolas Zaller
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Abstract

Background: The COVID-19 pandemic catalyzed a rapid shift in healthcare delivery towards telehealth services, impacting patient care, including opioid use disorder (OUD) treatment. Regulatory changes eliminated the in-person evaluation requirement for buprenorphine treatment, encouraging adoption of telehealth. This study focused on understanding experiences of primary care providers in predominantly rural areas who used telehealth for OUD treatment during the pandemic.

Methods: Semi-structured interviews were conducted with 22 primary care providers. Participants practiced in 13 rural and 9 urban counties in Kentucky and Arkansas. Data were analyzed using conventional content analysis.

Results: The pandemic significantly impacted healthcare delivery. While telehealth was integrated for behavioral health counseling, in-person visits remained crucial, especially for urine drug screenings. Telehealth experiences varied, with some facing technology issues, while others found it efficient. Telehealth proved valuable for behavioral health counseling and sustaining relationships with established patients. Patients with OUD faced unique challenges, including housing, internet, transportation, and counseling needs. Stigma surrounding OUD affected clinical relationships. Building strong patient-provider relationships emerged as a central theme, emphasizing the value of face-to-face interactions. Regarding buprenorphine training, most found waiver training helpful but lacked formal education.

Conclusion: This research offers vital guidance for improving OUD treatment services, especially in rural areas during crises like the COVID-19 pandemic. It highlights telehealth's value as a tool while acknowledging its limitations. The study underscores the significance of strong patient-provider relationships, the importance of reducing stigma, and the potential for training programs to elevate quality of care in OUD treatment.

初级保健提供者在 COVID-19 大流行期间利用远程保健治疗阿片类药物使用障碍的经验。
背景:COVID-19 大流行促使医疗服务迅速转向远程医疗服务,影响了患者护理,包括阿片类药物使用障碍 (OUD) 治疗。监管方面的变化取消了丁丙诺啡治疗的亲自评估要求,鼓励采用远程医疗。本研究的重点是了解主要是农村地区的初级医疗服务提供者在大流行期间使用远程医疗进行 OUD 治疗的经验:对 22 名初级医疗服务提供者进行了半结构化访谈。参与者在肯塔基州和阿肯色州的 13 个农村县和 9 个城市县执业。采用传统的内容分析法对数据进行了分析:结果:大流行严重影响了医疗服务的提供。虽然远程医疗被整合到了行为健康咨询中,但面对面就诊仍然至关重要,尤其是尿液药物筛查。远程医疗的经验各不相同,有些人面临技术问题,而另一些人则认为远程医疗很高效。事实证明,远程保健对于行为健康咨询和维持与既有患者的关系很有价值。OUD 患者面临着独特的挑战,包括住房、网络、交通和咨询需求。围绕 OUD 的污名化影响了临床关系。建立稳固的患者-医护人员关系是一个核心主题,强调了面对面交流的价值。关于丁丙诺啡培训,大多数人认为豁免培训很有帮助,但缺乏正规教育:这项研究为改善 OUD 治疗服务提供了重要指导,尤其是在 COVID-19 大流行等危机期间的农村地区。它强调了远程保健作为一种工具的价值,同时也承认了其局限性。该研究强调了患者与医疗服务提供者之间牢固关系的重要性、减少污名化的重要性以及培训计划在提高 OUD 治疗质量方面的潜力。
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
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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