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Accepted for/Published in: JMIR Public Health and Surveillance

Date Submitted: May 4, 2022
Date Accepted: Jun 6, 2023

The final, peer-reviewed published version of this preprint can be found here:

Co-Constructing a Community-Based Telemedicine Program for People With Opioid Use Disorder During the COVID-19 Pandemic: Lessons Learned and Implications for Future Service Delivery

Høj SB, de Montigny C, Chougar S, Léandre R, Beauchemin-Nadeau M�, Boyer-Legault G, Goyette A, Lamont SK, Bruneau J

Co-Constructing a Community-Based Telemedicine Program for People With Opioid Use Disorder During the COVID-19 Pandemic: Lessons Learned and Implications for Future Service Delivery

JMIR Public Health Surveill 2023;9:e39236

DOI: 10.2196/39236

PMID: 37494097

PMCID: 10413226

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Co-constructing a community-based telemedicine program for people with opioid use disorder during COVID-19: Implications for future service delivery

  • Stine Bordier Høj; 
  • Catherine de Montigny; 
  • Sofiane Chougar; 
  • Robert Léandre; 
  • Marie-Ève Beauchemin-Nadeau; 
  • Geneviève Boyer-Legault; 
  • Amélie Goyette; 
  • Sara-Kim Lamont; 
  • Julie Bruneau

ABSTRACT

The COVID-19 pandemic triggered unprecedented expansion of telemedicine, including in the delivery of opioid agonist treatment (OAT) for people with opioid use disorder (PWOUD). However, many PWOUD lack the technological resources necessary for remote care, have complex needs, or are disengaged from mainstream services. To address the needs of these individuals, a unique program delivering telemedicine with the support of community outreach workers was co-constructed in Montreal, Canada, by the addiction medicine service of the Centre hospitalier de l’Université de Montréal (CHUM-A) and CACTUS Montréal, a community-based harm reduction organisation known and trusted by its clientele. Procedures were developed jointly to enable flexible and rapid appointment scheduling. CACTUS Montréal workers promoted the program, facilitated private on-site telemedicine connections and warm handoff to the CHUM-A team, accompanied patients during online appointments if requested, and provided ongoing holistic support and follow-up. The CHUM-A team offered individualized OAT regimens and other health services as needed. Between April 2020 and March 2022, 75 people initiated OAT through the program. In March 2022, 88% remained engaged in care, exceeding reported 1-year OAT retention rates of 30-70%. Five participants commenced HIV treatment and 16 were treated for hepatitis C. Overall, participants perceived the initiative to be convenient, non-judgmental, and responsive to their needs; the implication of CACTUS Montréal was highly valued and integral to these outcomes. Beyond the pandemic context, our program presents a flexible and accessible means to deliver alternative treatment options for PWOUD disengaged from traditional care, bridge gaps between communities and health providers, and improve access to care in rural/remote settings.


 Citation

Please cite as:

Høj SB, de Montigny C, Chougar S, Léandre R, Beauchemin-Nadeau M�, Boyer-Legault G, Goyette A, Lamont SK, Bruneau J

Co-Constructing a Community-Based Telemedicine Program for People With Opioid Use Disorder During the COVID-19 Pandemic: Lessons Learned and Implications for Future Service Delivery

JMIR Public Health Surveill 2023;9:e39236

DOI: 10.2196/39236

PMID: 37494097

PMCID: 10413226

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