THURSDAY, Oct. 14, 2021 — The coronavirus pandemic forced a significant shift to telemedicine treatment for addiction, but it’s not clear whether that approach is better than in-person care, a new study finds.
Before the pandemic, addiction treatment services in the United States had many restrictions on telemedicine use, so only about 27% of addiction facilities offered telehealth services, while telehealth was used in just 0.1% of addiction treatment visits.
Many of those restrictions were eased by state and federal agencies during the pandemic so that patients could still access treatment, triggering rapid growth in telehealth use. Now, the big question is, which of those restriction changes should be kept.
To examine the issue, the researchers reviewed eight published studies that compared telehealth and in-person addiction treatment. Most of them included less than 150 patients.
Seven of the studies concluded that telehealth treatment was effective, but not more effective than in-person treatment in terms of retention, satisfaction with treatment, therapeutic alliance and substance use.
One large Canadian study found that telehealth methadone medication management was associated with better patient retention, according to the study published online Oct. 13 in the journal Psychiatric Services.
The researchers also conducted an online survey of addiction treatment organizations in California.
Respondents were almost equally divided on the effectiveness of telehealth individual counseling, with about 46% saying it was equally or more effective than in person and 45% saying it was less effective.
In terms of intake assessment, 40% said telehealth was equally or more effective, while 49% said it was less effective than in person. Only 25% said telehealth group counseling was equally or more effective than in person, and 62% said it was less effective.
The researchers also conducted interviews with addiction treatment specialists and other stakeholders, who said that telehealth reduces patients’ time and cost to receive treatment, and enables clinicians to observe patients’ home environment and engage their families.
However, many of those interviewed felt strongly that patients require personal relationships and connectedness, which are difficult to establish virtually.
They also said it’s more difficult to sense how a patient is doing when using telehealth and it can be challenging to keep patients focused online.
“Telehealth health may allow patients to more easily begin and stay in addiction treatment, which has been a longstanding challenge,” said study author Tami Mark, a senior fellow in behavioral health financing and quality measurement at RTI International, a nonprofit research institute in Rockville, Md.
“However, research is needed to confirm this benefit,” Mark said in a journal news release. “As providers pivot to hybrid telehealth models — offering both telehealth and in-person treatment — they need information to help target telehealth to the most appropriate services and patients.”
- Psychiatric Services, news release, Oct. 13, 2021
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Posted October 2021