Journal of substance use and addiction treatment · 2025
Retention rates and cost-effectiveness of telehealth vs. in-person buprenorphine treatment for opioid use disorder (OUD).
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Saad Rana, Roberts Melissa H, Salvador Julie G, Bhatt Snehal R, Borrego Matthew E
Аннотация
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.
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.