JMIR Publications

ABSTRACT

Background:

Utilization of virtual treatment services increased dramatically during the COVID-19 pandemic. Unfortunately, large-scale research on virtual treatment for substance use disorder (SUD), including factors that may influence outcomes, has not advanced with the rapidly changing landscape.

Objective:

This study aims to evaluate the link between clinician-level factors and patient outcomes in populations receiving virtual and in-person intensive outpatient services.

Methods:

Data came from patients (n=1410) treated in virtual (VIOP) and in-person intensive outpatient programming (IOP), who discharged between January 2020 and March 2021 from a national treatment organization. Patient data were nested by treatment provider (n=58) examining associations with no-shows and discharge with staff approval. Empathy, comfort with technology, perceived stress, resistance to change, and demographic covariates were examined at the clinician level.

Results:

VIOP (β=-5.71, p = 0.032) and the personal distress subscale measure (β=-6.31, p = 0.003) were negatively associated with the percentage of no-shows. VIOP was positively associated with discharges with staff approval (OR= 2.38, 95% CI=1.50, 3.76). Clinician scores on perspective taking (β=-9.22, p = 0.02), personal distress (β=-9.44, p = 0.017) and male clinician gender (β=-6.43, p = 0.041) were negatively associated with in-person no-shows. Patient load was positively associated with discharge with staff approval (OR= 1.04, 95% CI=1.02, 1.06).

Conclusions:

Overall, patients in VIOP had fewer no-shows and a higher rate of successful discharge. Few clinician-level characteristics were significantly associated with patient outcomes. Further research is necessary to understand the relationships between factors such as clinician gender, patient load, personal distress, and patient retention.