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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
Based on a literature review, the article synthesizes strategies used to prevent interruption of care for persons with opioid use disorders (SUDs). The review included OUD treatment and harm reduction services in five continents and a range of settings from substance use treatment to street outreach programs. Innovative service modifications to adapt to COVID-19 circumstances primarily involved expanded use of telehealth services (e.g., telemedicine visits for buprenorphine, virtual individual or group therapy sessions, provision of donated or publicly available phones), increased take-home medication allowances for methadone and buprenorphine, expanded uptake of long-acting opioid medications (e.g. extended-release buprenorphine and naltrexone), home delivery of services (e.g. MOUD, naloxone and urine drug screening), outreach and makeshift services for delivering MOUD and naloxone, and provision of a safe supply of opioids.
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 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 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.
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 describes the Rhode Island Buprenorphine Hotline, a “tele-bridge” clinic where patients undergo screening and, if appropriate, are prescribed buprenorphine for induction. This is a new model enabled by changes in federal guidance in response to the COVID-19 pandemic. Evaluation of the hotline is ongoing, but initial reception among hotline users and providers is positive. The practice strategy this article is focused on is promoting access to medication assisted treatment for individuals with opioid use disorder during the COVID-19 pandemic.