February 1, 2023

The program offers a virtual assessment and treatment of buprenorphine, an opioid craving and withdrawal drug.

According to researchers at the University of Pennsylvania’s Perelman School of Medicine, more than half of patients prescribed an opioid use disorder drug through a virtual program set up during the pandemic continued treatment for at least a month after the program.

The CareConnect program was created through a partnership between Penn Medicine OnDemand, the University of Pennsylvania’s 24/7 virtual emergency care, and a team of drug use navigators. Trained emergency medical professionals offer a virtual assessment and treatment with buprenorphine, an opioid craving and withdrawal medication. Patients are also supported by substance use navigators throughout the treatment process.

The results show that 89% of patients in the program filled their first prescription of buprenorphine. Additionally, 30 days after the initial engagement, 55% still had an “active prescription” for the drug, according to the study authors, indicating they are still actively on treatment.

“The numbers are encouraging and possibly even an underestimate when it comes to who is in active treatment because they don’t capture people on other forms of care, such as methadone, or those who have entered inpatient rehabilitation,” said the study’s author , Margaret Lowenstein, MD, assistant professor of medicine and research director of the Penn Center for Addiction Medicine and Policy (CAMP), in a press release.

Due to the COVID-19 pandemic, emergency prescriptions for buprenorphine were suspended, allowing CAMP to develop a predecessor to CareConnect. The telemedicine-based pilot service provided short-term prescriptions for buprenorphine and connected patients to longer-term treatment services. These services included additional prescriptions for buprenorphine or other medications, care for other chronic conditions, and connections to social services.

This also allowed patients who may be treated in emergency departments to avoid the hospital and access treatment without having to travel, which has been identified as a significant barrier for some patients, particularly during the COVID-19 pandemic.

The pilot program helped patients overcome treatment barriers; But investigators said there was no infrastructure to plan or efficiently document care, among other areas that would need to be put in place for a broad-based program.

“The power of a program like this is that it fills all the gaps: for the average patient seeking treatment, there are few, if any, places that can offer same-day or next-day treatment, and even then patients must navigate a variety of obstacles such as childcare or transportation,” Lowenstein said in a press release. “CareConnect enables patients to receive their prescription for buprenorphine as soon as they need it and provides the help needed to overcome any hurdles a patient faces until they can be firmly connected to care.”

Another benefit of the program was the support it offers to patients transitioning between different levels of care, such as: B. Discharge after hospitalization and return to an ambulatory care service.

“Hospital physicians call on CareConnect knowing their patients will be supported through every step needed to make this transition,” senior author Jeanmarie Perrone, MD, professor of emergency medicine and founding director of CAMP, said in a press release. “Also, other ERs in the area are beginning to prescribe buprenorphine and are calling CareConnect to arrange follow-up and ‘warm handover’ to the next provider. This expands the safety net for patients to find treatment more easily.”

The study found that from November 2021 to September 2022, the program received 371 calls and issued 249 buprenorphine prescriptions. The study’s authors said they hope to expand the program to a broader population in the future.

“This is one of the few places in Philadelphia that offers consistent same-day access to buprenorphine treatment,” Lowenstein said in a press release. “The alternative is often an emergency room or a crisis center or, in the worst case, leaving without care. So we’re talking about saving hundreds of ER visits and/or hundreds of people from being careless.”

A NOTICE

The CareConnect telemedicine program helps remove barriers to opioid use disorder treatment. November 16, 2022. Accessed November 17, 2022. https://www.pennmedicine.org/news/news-releases/2022/november/careconnect-lowers-opioid-use-disorder-treatment-barriers

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