Telehealth addiction treatment rose rapidly during pandemic; but
potential benefits still unclear

Date:
October 13, 2021
Source:
American Psychiatric Association
Summary:
During the COVID-19 pandemic, addiction treatment providers
rapidly pivoted to providing services via telehealth. New research
highlights the potential for telehealth delivery to increase
patient engagement by improving access and convenience. However,
it also finds limited evidence that telehealth results in better
retention or other outcomes relative to in-person treatment.



FULL STORY ========================================================================== During the COVID-19 pandemic, addiction treatment providers rapidly
pivoted to providing services via telehealth. New research highlights
the potential for telehealth delivery to increase patient engagement
by improving access and convenience. However, it also finds limited
evidence that telehealth results in better retention or other outcomes
relative to in-person treatment. The research appears online today in Psychiatric Services a journal of the American Psychiatric Association,
ahead of the organization's Mental Health Services Conference.


========================================================================== Prior to the COVID-19 pandemic, only about 27% of specialty addiction facilities had telehealth capabilities and telehealth was used in about
0.1% of addiction treatment visits. Addiction treatment services faced
many restrictions on telehealth use. During the pandemic, state and
federal agencies temporarily eased many of the restrictions to maintain
access to treatment and use of telehealth expanded rapidly. Policymakers
are now considering which of these changes to keep.

Researchers from RTI International and UCLA -- University of California,
Los Angeles reviewed studies of the efficacy of synchronous delivery of telehealth addiction treatment relative to in-person treatment. Eight
published studies were identified that compared addiction treatment
via telehealth with in-person treatment. Most of the studies were small
(N < 150 patients). Seven found telehealth treatment as effective but
not more effective in terms of retention, satisfaction with treatment, therapeutic alliance and substance use. One large Canadian study found
better retention with telehealth methadone medication management.

The researchers also conducted an online survey of addiction treatment organizations in California and held interviews with addiction
professionals and other stakeholders. Addiction professionals were most comfortable with using telehealth for one-to-one counseling. Survey
respondents were almost equally split with about 46% saying telehealth individual counseling was equally or more effective than in-person and 45% saying telehealth was less effective. When considering use of telehealth
for intake assessment, 40% said telehealth was equally or more effective
while 49% said it was less effective.

Telehealth group counseling had less support with 25% reporting it was
equally or more effective than in person and 62% reporting it was less effective than in person.

Interview participants highlighted that telehealth reduces the time and
cost to patients of participating in treatment and offers an opportunity
for clinicians to observe patients' home environment and engage
patients' families. On the other hand, many participants felt strongly
that patients with substance use disorders need personal relationships
and connectedness which are hard to establish virtually. Additionally,
they noted that it is more difficult to sense how a patient is doing
when meeting via telehealth and it can be challenging to keep patients
focused online. Interviewees also noted that telehealth may work better
for some patients and for some clinicians than for others.

"Telehealth health may allow patients to more easily begin and stay
in addiction treatment, which has been a longstanding challenge," said
Tami L.

Mark, Ph.D., M.B.A., lead author on the paper. "However, research is
needed to confirm this benefit. 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." "This research underscores the importance of offering telehealth for addiction treatment and the dramatic need to conduct more empirical work to test out the concerns regarding telehealth articulated
by agency staff and on surveys," said Lisa Dixon, M.D., M.P.H., editor, Psychiatric Services.

Mark is senior fellow, Behavioral Health Financing and Quality Measurement
at RTI International, an independent nonprofit research institute
dedicated to improving the human condition. The study's coauthors include Katherine Treiman, Ph.D., M.P.H., Howard Padwa, Ph.D., Kristen Henretty,
M.A., Janice Tzeng, M.P.H., and Marylou Gilbert, M.A., J.D.

========================================================================== Story Source: Materials provided by
American_Psychiatric_Association. Note: Content may be edited for style
and length.


========================================================================== Journal Reference:
1. Tami L. Mark, Katherine Treiman, Howard Padwa, Kristen Henretty,
Janice
Tzeng, Marylou Gilbert. Addiction Treatment and Telehealth:
Review of Efficacy and Provider Insights During the COVID-19
Pandemic. Psychiatric Services, 2021; DOI: 10.1176/appi.ps.202100088 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/10/211013131602.htm

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