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Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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White Paper/Brief
This article discusses the Foundation for Opioid Response Efforts (FORE) distribution of $1.3 million in grants to organizations studying the potential permanent adoption of COVID-19 care access measures to promote health equity in opioid use disorder treatment. The grants aim to investigate the impact of temporary policies, such as virtual care, on access to care and patient outcomes. The studies will explore how relaxed prescribing policies for buprenorphine, telehealth strategies, and other COVID-19 measures have affected patient access and outcomes, particularly among underserved populations. The research will inform evidence-based policies to sustain access to better care beyond the pandemic and address the ongoing opioid crisis.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study, Summary Report/Recommendations
Article outlines how an opioid treatment program in the Bronx, NY adjusted their clinical practice with COVID-19 and their recommendations for treatment programs going forward. Balancing Covid-19 safety and the need to safely administer medications for opioid use disorder, this program ultimately made changes that allowed for more patient-driven treatment plans that enable fewer in person clinic visits. The article advocates for patient-centered care that encourages people to safely self-manage medication, focusing on patient-centered measures in clinical decision-making, and making appropriate changes to payment/insurance models that allow for such patient-centered care.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This article conducts a retrospective case-control study of electronic health records of individuals who were diagnosed with COVID-19 and have a recent diagnosis of substance use disorder (SUD). The results show that those diagnosed with SUD, particularly African Americans and those with opioid use disorder (OUD), are more likely to contract COVID-19, as well as suffer worsening outcomes such as hospitalization and mortality due to COVID-19. This article shows that an increase in SUD screening could be a factor in mitigating the spread of COVID-19 in this community.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study uses electronic medical records to categorize ethnic differences in clinical presentation and outcomes from COVID-19 among older adults. The data showed no difference in outcomes, hospitalizations, or death between older Hispanic adults and non-Hispanic patients with COVID-19.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study examined telemedicine utilization patterns for one healthcare system during the COVID-19 pandemic to determine if environmental, racial or ethnic, or other social determinants of health impact an individual’s access and usage of telemedicine. Results showed that older age, rural status, and lower socioeconomic status, as well as Asian, Black, and Hispanic ethnicities are most likely to be associated with a lower telemedicine use. Efforts toward digital literary outreach and distribution of telemedicine infrastructure are needed.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study used data from Mass General Brigham in Boston, Mass., to identify the drivers of differences in use of telemedicine and telehealth during the COVID-19 pandemic. Results found that Hispanic adults older than 65 with limited English proficiency were more likely to experience a digital divide in health care.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
A retrospective registry-based chart review examined the various demographic and clinical risk factors associated with COVID-19 severity among patients aged 18-29. The study was done within a metropolitan health care system in Houston, TX. In the cohort of 1,853 young adult patients diagnosed with COVID-19 infection at a hospital encounter, including 226 pregnant women, 1,438 (78%) scored 0 on the Charlson Comorbidity Index, and 833 (45%) were obese (≥30 kg/m2). Within 30 days of their diagnostic encounter, 316 (17%) patients were diagnosed with pneumonia, 148 (8%) received other severe disease diagnoses, and 268 (14%) returned to the hospital after being discharged home. In multivariate logistic regression analyses, increasing age, male gender, Hispanic ethnicity, obesity, asthma history, congestive heart failure, cerebrovascular disease, and diabetes were predictive of severe disease diagnoses within 30 days. Non-Hispanic Black race, obesity, asthma history, myocardial infarction history, and household exposure were predictive of 30-day readmission.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study describes harm reduction and health services provided by the U.S. syringe services programs (SSPs) in 2019 and changes in provision of those services in 2020. Many SSPs that offered health services in 2019 and remained operational in 2020 increased telehealth provision of mental health and primary care services, increased MOUD provision, and expanded harm reduction services, but most SSPs reduced or stopped on-site HIV and HCV testing. With the record high opioid overdose fatality rates in 2020, sustaining the trajectory of SSP growth and innovation leading up to and through 2020 requires ensuring adequate and flexible funding to support the life-saving work of SSPs in preventing future overdose deaths and outbreaks of HIV and HCV.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study
This article summarizes COVID-19 harm reduction approaches taken by a family medicine/OBGYN residency program serving rural, western North Carolina for patients with an opioid use disorder. To meet patient needs, low acuity patients were offered telehealth options and digital prescriptions for buprenorphine/naloxone. For higher acuity patients, in=person visits were maintained and the risk/benefits were weighed on a continuous basis.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Peer Review Study
The article describes a practice based on training community health workers (CHWs) to present oral health information one-on-one to older Chinese adult patients. More than 98% of participants agreed that CHWs helped them improve their oral health and satisfactorily answered their questions/concerns.