Recent Trends in Telehealth for Substance Use Disorder Services: A Comparison of Utilization Rates During and Following COVID-19 Safety Distancing Recommendations (Preprint)

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Abstract
BACKGROUND The COVID-19 social distancing guidelines resulted in a dramatic transition to telephone and video technologies to deliver substance use disorder (SUD) treatment. Before COVID-19, the question was, “Would telehealth would ever take hold for SUD services?” Now that social distancing guidelines have been lifted, the question is, “Will telehealth remain a commonly used care modality?” The principal purpose of the investigation was to examine the extent to which telehealth use in SUD service settings persisted following the lifting of COVID-19 safety distancing recommendations. Additionally, the study aimed to explore practitioners’ perceptions of telehealth convenience and value after its regular implementation. OBJECTIVE Compare and contrast telehealth activity between time intervals: May–August 2020 (during peak COVID-19 safety distancing recommendations) and October–December 2022 (following discontinuation of distancing recommendations), for a) telehealth technologies and services, b) perceived usefulness of telehealth, c) ease of use of telephone- and video-based telehealth services, and d) organizational readiness to use telehealth. METHODS An online survey measured the use of telehealth technologies for delivering a specific set of SUD services and explored the perceived readiness to use and satisfaction with telephonic and video services using identical scales of a previously published telehealth utilization study by [1]. Six of 10 Regional Addiction Technology Transfer Centers (ATTCs) distributed the survey in their respective regions, collectively spanning 37 states. Staff member responses from this 2022 cross-sectional survey were compared to staff member responses in the 2020 cross-sectional survey. Staff member responses in 2020 and 2022 were anonymous and comprised two separate samples, so an accurate longitudinal model could not be analyzed. RESULTS A total of 375 organizations responded to the 2022 survey (vs. 457 in 2020). Baseline organizational characteristics were similar to the 2020 sample. Telephone and video telehealth use remained >50% for screening and assessment, case management, peer recovery support services, and regular outpatient services. Yet, nearly all SUD services delivered by phone and video significantly declined from 2020 to 2022, while perceived usefulness and ease of use of telehealth did not significantly change from 2020 to 2002 for most SUD services. CONCLUSIONS Despite lower telephone and video utilization, both video-based and telephonic modalities for telehealth service continue to be perceived positively. Future research may further determine the relative cost and clinical effectiveness of video-based services, and thereby help to address some sources of the noted challenges to implementation by SUD organizations.

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