JMIR Publications

ABSTRACT

Background:

Patients using buprenorphine for opioid use disorder (OUD) or long-term opioid therapy for chronic pain are at risk for poor outcomes if care is interrupted. Both treatments are highly regulated, with pre-pandemic requirements for in-person care. COVID-19 may have resulted in barriers for accessing in-person care but also opportunities for improved access through telemedicine.

Objective:

The objective was to evaluate changes in healthcare utilization and telemedicine use during the COVID-19 pandemic among patients using buprenorphine for OUD and long-term opioid therapy for chronic pain.

Methods:

We used administrative claims data for commercially insured and Medicare Advantage patients from the OptumLabs® Data Warehouse. We included patients using buprenorphine for OUD or long-term opioid therapy for chronic pain compared to patients with another chronic condition: serious mental illness (SMI). We evaluated changes in in-person and telemedicine care by comparing rates of services by physician specialty and the percentage of visits through telemedicine. Changes in utilization were measured using Poisson regression.

Results:

We found declines in in-person visits in April 2020, but smaller declines for specialties that could more easily transition to telemedicine like family practice (30-36% telemedicine visits), mental health (45-50%), and pain medicine (48-51%). The percentage of telemedicine visits remained elevated for family practice (10-14%), mental health (34-43%), and pain medicine (11-15%) through January 2022.

Conclusions:

These findings highlight the value of telemedicine to maintain access among people at risk for poor outcomes if care is interrupted. Extending access to telemedicine beyond the pandemic period may benefit vulnerable patient populations.