Details

Autor(en) / Beteiligte

• Meyerson, Beth E.
• Bentele, Keith G.
• Brady, Benjamin R.
• Stavros, Nick
• Russell, Danielle M.
• Mahoney, Arlene N.
• Garnett, Irene
• Jackson, Shomari
• Garcia, Roberto C.
• Coles, Haley B.
• Granillo, Brenda
• Carter, Gregory A.

Titel

Insufficient Impact: Limited Implementation of Federal Regulatory Changes to Methadone and Buprenorphine Access in Arizona During COVID-19

Ist Teil von

• AJPM Focus, 2024-04, Vol.3 (2), p.100177-100177, Article 100177

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •This study measured the implementation of COVID-19 medication for opioid use disorder accommodations across 3 time periods.•Multiday dosing was the only accommodation substantially retracted after COVID-19 shutdown.•Nearly half (43%) of all providers were unaware of the allowed COVID-19 regulatory flexibilities.•Federal regulatory changes did not produce a sustained impact on patient medication for opioid use disorder accommodations. This study examined the impact of federal regulatory changes on methadone and buprenorphine treatment during COVID-19 in Arizona. A cohort study of methadone and buprenorphine providers from September 14, 2021 to April 15, 2022 measured the proportion of 6 treatment accommodations implemented at 3 time periods: before COVID-19, during Arizona's COVID-19 shutdown, and at the time of the survey completion. Accommodations included (1) telehealth, (2) telehealth buprenorphine induction, (3) increased multiday dosing, (4) license reciprocity, (5) home medications delivery, and (6) off-site dispensing. A multilevel model assessed the association of treatment setting, rurality, and treatment with accommodation implementation time. Over half (62.2%) of the 74-provider sample practiced in healthcare settings not primarily focused on addiction treatment, 19% practiced in methadone clinics, and 19% practiced in treatment clinics not offering methadone. Almost half (43%) were unaware of the regulatory changes allowing treatment accommodation. Telehealth was most frequently reported, increasing from 30% before COVID-19 to 80% at the time of the survey. Multiday dosing was the only accommodation substantially retracted after COVID-19 shutdown: from 41% to 23% at the time of the survey. Providers with higher patient limits were 2.5–3.2 times as likely to implement telehealth services, 4.4 times as likely to implement buprenorphine induction through telehealth, and 15.2–20.9 times as likely to implement license reciprocity as providers with lower patient limits. Providers of methadone implemented 12% more accommodations and maintained a higher average proportion of implemented accommodations during the COVID-19 shutdown period but were more likely to reduce the proportion of implemented accommodations (a 17-percentage point gap by the time of the survey). Federal regulatory changes are not sufficient to produce a substantive or sustained impact on provider accommodations, especially in methadone medical treatment settings. Practice change interventions specific to treatment settings should be implemented and studied for their impact. [Display omitted]