JMIR Form Res. 2022 Aug 9. doi: 10.2196/39772. Online ahead of print.
ABSTRACT
BACKGROUND: The emergence of COVID-19 exacerbated the existing epidemic of opioid use disorder (OUD) across the United States due to the disruption of in-person treatment and support services. Increased use of technology – including telehealth – and the development of new partnerships may facilitate coordinated treatment interventions that comprehensively address the health and well-being of individuals with OUD.
OBJECTIVE: The analysis of this pilot program aimed to determine the feasibility of delivering a COVID-19 telehealth care management program using Short Message Service (SMS) text messages for patients receiving OUD treatment.
METHODS: Eligible individuals were identified from a state-wide opioid treatment program (OTP) network. Those who screened positive for COVID-19 symptoms were invited to connect to care management through a secure, HIPPA-compliant SMS text message. Care management monitoring for COVID-19 was provided for a period of up to 14 days. Monitoring services consisted of daily text messages from the care manager inquiring about: 1) the participant’s physical health in relation to COVID-19 symptoms by confirming their temperature, 2) if the participant was feeling worse since the prior day, and 3) if the participant was experiencing symptoms such as coughing or shortness of breath. If COVID-19 symptoms worsened during this observation period, the care manager was instructed to refer participants to the hospital for acute care services. Feasibility of the telehealth care management intervention was assessed by rates of: 1) adoption in terms of program enrollment; 2) engagement as measured by the number of text message responses per participants; and 3) retention in terms of the number of days participants remained in the program.
RESULTS: Between January and April 2021, OTP staff members referred 21 patients with COVID-19 symptoms and 18 (82%) agreed to be contacted by a care manager. Participants ranged in age from 27-65 years and primarily identified as female (58%) and white (83%). The majority of participants were Medicaid recipients (78%). There were no statistically significant differences in the demographic characteristics between those enrolled and not enrolled in the program. A total of 12 (67%) patients were enrolled in the program with two (11%) opting out of text message communication and choosing instead to speak with a care manager verbally by telephone. The remaining 10 participants answered [median (interquartile range)] 7 (4-10) messages and were enrolled in the program for 9 (7.5-12) days. No participants were referred for acute care services or hospitalized during program enrollment.
CONCLUSIONS: These results demonstrate the feasibility of a novel telehealth intervention to monitor COVID-19 symptoms among OTP patients in treatment for OUD. Further research is needed to determine the applicability of this intervention to monitor patients with comorbid chronic conditions in addition to acceptability among patients and providers using the text messaging modality.
PMID:35973033 | DOI:10.2196/39772
