Addiction. 2023 Feb 3. doi: 10.1111/add.16156. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: The COVID-19 pandemic disrupted healthcare provision in the United States and prompted increases in telehealth-delivery of care. This study measured alcohol use disorder (AUD) treatment trends across visit modalities before and during COVID-19.
DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We conducted a national, retrospective cohort study with interrupted time series models to estimate the impact of COVID-19 on AUD treatment in the Veterans Health Administration (VHA) in the United States, during pre-COVID-19 (March 2019 to February 2020) and COVID-19 (March 2020 to February 2021) periods. We analyzed monthly trends in telephone, video and in-person visits for AUD treatment and compared patient and treatment characteristics of patients receiving AUD treatment between the pre-COVID-19 and COVID-19 periods. AUD was defined using International Classification of Diseases, 10th Revision (ICD-10) codes for alcohol abuse (F10.1) and alcohol dependence (F10.2) which have previously been used to study AUD in VHA.
FINDINGS: The predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the beginning of the pre-COVID period was 13.8% (n=49,494). The predicted percentage decreased by 4.3% (P=0.001) immediately at the start of the COVID-19 period due to a decline in AUD psychotherapy. Despite an increase of 0.3% per month (P=0.026) following the start of COVID-19, the predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the end of the study period remained below the pre-COVID-19 period. In February 2021, AUD psychotherapy visits were primarily delivered by video (50%, 58,748), followed by in-person (36.6%, 43,251) and telephone (13.8%, 16,299), while AUD pharmacotherapy visits were delivered by telephone (38.9%, 3,623) followed by in-person (34.3%, 3,193) and video (26.8%, 2,498) modalities. Characteristics of VHA patients receiving AUD treatment were largely similar between pre-COVID-19 and COVID-19 periods.
CONCLUSIONS: Despite increased telehealth use, the percentage of US Veterans Health Administration patients with an alcohol use disorder (AUD) diagnosis receiving AUD treatment declined during COVID-19 (March 2020 to February 2021) mainly due to a decrease in psychotherapy.
PMID:36738085 | DOI:10.1111/add.16156
