Retention rates and cost-effectiveness of telehealth vs. in-person buprenorphine treatment for opioid use disorder (OUD)

IF 1.9 0 PSYCHOLOGY, CLINICAL

Journal of substance use and addiction treatment Pub Date : 2025-07-30 DOI:10.1016/j.josat.2025.209764

Rana Saad , Melissa H. Roberts , Julie G. Salvador , Snehal R. Bhatt , Matthew E. Borrego

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Abstract

Background

Management of opioid use disorder (OUD) has evolved with integration of telehealth, particularly during COVID-19. This study evaluated effectiveness (retention to therapy) and cost-effectiveness of office-based versus telehealth buprenorphine treatment for OUD.

Methods

Retrospective chart review included 135 buprenorphine-treated patients at a New Mexico addiction and substance abuse program. Patients were categorized by treatment modality (office-based vs. telehealth). Retention, the effectiveness measure, was defined as continuous OUD treatment for ≥180 days. Logistic regression estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for retention, controlling for demographics. Incremental cost-effectiveness ratios (ICERs) were calculated for direct medical, direct non-medical (transportation), and indirect costs (productivity losses) from a societal perspective.

Results

Analyses showed no statistically significant difference in retention between office-based (51 %) and telehealth (42 %) modalities (p > 0.05). Males were less likely to remain in treatment (OR = 0.48 [95 % CI: 0.24–0.96], p = 0.04). Female retention rates were high (58 % in both modalities). Male rates were lower for office-based (45 %) and telehealth (34 %). The ICER analysis indicated that office-based modalities incurred additional costs of $3750 per 1 % increase in retention compared to telehealth, suggesting higher overall costs for retained patients in the office-based modality.

Conclusion

OUD patient retention rates were not significantly different between treatment modalities. However, office-based treatment incurred higher costs, emphasizing telehealth's potential as a cost-effective alternative. Future research should explore long-term outcomes, sex differences in treatment adherence, and the integration of telehealth into standard practice to enhance resource allocation and treatment accessibility.

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远程医疗与丁丙诺啡亲自治疗阿片类药物使用障碍的保留率和成本效益。

背景：阿片类药物使用障碍（OUD）的管理随着远程医疗的整合而发展，特别是在COVID-19期间。本研究评估了办公室丁丙诺啡治疗OUD与远程医疗丁丙诺啡治疗的有效性（治疗持续时间）和成本效益。方法：回顾性分析新墨西哥州成瘾和药物滥用项目中135例丁丙诺啡治疗的患者。患者按治疗方式（办公室与远程医疗）进行分类。保留度，有效性衡量标准，定义为连续OUD治疗≥180 天。Logistic回归估计了保留率的比值比（ORs）和95% %置信区间（CIs），控制了人口统计学因素。从社会角度计算了直接医疗、直接非医疗（运输）和间接成本（生产力损失）的增量成本效益比（ICERs）。结果：分析显示，办公室医疗（51% %）和远程医疗（42% %）模式之间的保留率无统计学差异（p > 0.05）。男性坚持治疗的可能性较小（OR = 0.48[95 % CI: 0.24-0.96], p = 0.04）。女性保留率高（58% %在两种方式）。男性在办公室（45% %）和远程医疗（34% %）中的发病率较低。ICER分析表明，与远程医疗相比，以办公室为基础的模式每增加1 %的留用病人就会产生3750美元的额外费用，这表明以办公室为基础的模式留用病人的总费用更高。结论：不同治疗方式的患者保留率无显著差异。然而，办公室治疗的费用较高，这强调了远程保健作为一种具有成本效益的替代办法的潜力。未来的研究应探讨长期结果、治疗依从性的性别差异，以及将远程医疗纳入标准实践，以加强资源分配和治疗可及性。

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

Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)

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