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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.
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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Systematic Review/Meta-Analysis
This review of state data collection and reporting practices during the COVID-19 pandemic found inconsistencies and gaps in data collected by race and ethnicity. Improved standardization across the U.S.–which may come in the form of a federally-operated centralized database–would address some of the concerns in data representation of all Americans.
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.
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.
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
This article describes how the Northwest Portland Area Indian Health Board (NPAIHB) telehealth program, known as Extensions for Community Healthcare Outcomes (ECHO), or teleECHO, adapted to COVID-19 in providing community clinicians/public health workers access to experts. Descriptions of how healthcare providers and staff adapted practices to be culturally responsive to tribal communities is presented.
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.
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 article presents the results of a non-randomized controlled trial comparing in-person vs. telemedicine treatment for pregnant women with opioid use disorder in South Carolina. The authors found no statistically significant difference in treatment outcomes for women who received care in-person vs. via telemedicine, and no statistically significant difference in outcomes for the newborns of women in these respective groups. The authors were unable to assign trial participants to telemedicine vs. in-person care at random due to the inability of some rural patients to attend treatment in person. Also, the sample size was not sufficient to achieve ~80% power to detect a difference between the two groups. At the same time, the practice strategy is considered useful for helping to deliver telehealth treatment for vulnerable populations, including pregnant and newly parenting people with substance use disorder, and people living in rural communities.
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.
RELEASE DATE:
Peer Review Study
This article details the results of a randomized clinical trial evaluating web-based versus in-person substance use disorder counseling. While participants who completed the study reported similar levels of satisfaction with treatment, and similar rates of attendance and drug-positive urinalysis results, it should be noted that most study withdrawal occurred among participants assigned to the web-based intervention, with 26 participants withdrawing due to problems with computer or internet function. If this program were replicated in other settings, the digital divide could pose a barrier to equitable outcomes. The practice strategy this article is focused on is telemedicine for treatment of substance use disorder.
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.
RELEASE DATE:
Peer Review Study
This article describes the rapid scale-up of adolescent telehealth services at the Children’s Hospital of Philadelphia (CHOP) Division of Adolescent Medicine. While the scale-up was partially effective in reaching some underserved populations (e.g., people living with HIV, people with substance use disorder, people living with mental illness), racial disparities in visit completion rates are concerning and would need to be addressed by sites replicating this intervention to avoid exacerbating health disparities. The practice strategy this article is focused on is adolescent telehealth services.