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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 presents results from an intervention to provide medication assisted treatment (MAT) to individuals with opioid use disorder via telemedicine. This article describes outcomes for patients enrolled in the NYC Health+Hospitals Virtual Buprenorphine Clinic during the first nine weeks of the COVID-19 pandemic (March 26, 2020 through May 28, 2020). Results from this evaluation were mixed. Loss-to-follow-up was similar to rates observed in studies of in-person opioid treatment, but the authors note telemedicine-based opioid treatment poses barriers to patients who frequently change mobile phones or phone numbers, and patients with unreliable internet access. The authors also note that the generalizability of this intervention may be limited in settings with different patient populations or staff capacity.
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 evaluates a partnership between the University of Maryland, Baltimore – an urban academic treatment center – and multiple rural behavioral health treatment centers to provide medication assisted treatment (MAT) to individuals with opioid use disorder via videoconference. Retention rates and toxicology results for patients who received MAT via videoconference were comparable to those receiving face-to-face treatment. It should be noted that data for this study were collected prior to the onset of the COVID-19 pandemic.
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 cohort study comparing opioid agonist therapy (medication assisted treatment [MAT]) for opioid use disorder received via telemedicine, in-person, or a mix of telemedicine and in-person visits. The study was conducted between January 2011 and June 2012 in Ontario, Canada. The telemedicine group had the highest one-year treatment retention rate, followed by the mixed group, and the in-person group had the lowest one-year treatment retention rate. The results suggest telemedicine could be an effective means of increasing access to MAT for opioid use disorder. It should be noted that the study was conducted prior to the COVID-19 pandemic, and replicability will vary based on local resources and MAT regulations.
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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Summary Report/Recommendations
This report highlights COVID-19 responses that benefit dually eligible individuals, including effective communication, supporting community members/caregivers, residential care facilities, and care transitions.
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 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.
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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Summary Report/Recommendations
This article focuses on post-pandemic treatment for individuals with substance use disorder. Specifically, this article identifies seven pillars to improve treatment for individuals with substance use disorders in the wake of the COVID-19 pandemic: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three “best buys” of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information.
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.
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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Commentary
This article describes strategies used to mitigate the impact of the COVID-19 pandemic on patients enrolled in a clinical trial providing patient navigation to pregnant mothers with opioid use disorder (OUD). The practice strategy this article is focused on is mitigating the effects of the pandemic on pregnant women with OUD, particularly those also experiencing intimate partner violence.
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
The Rebuilding Neighborhoods Initiative convened community organizers, small business owners, and corporations in the technology and innovation sector to develop community-centered, implementable solutions addressing gentrification and the lack of affordable housing in three greater Boston neighborhoods. Six monthly meetings were held on topics related to affordable housing. Each neighborhood had a team of 5-6 individuals who were developing and committing to shared goals towards equitable development.