Factors Associated With Telehealth Buprenorphine Initiation.

Area of Science:

• Addiction Medicine
• Health Services Research
• Digital Health

Background:

• COVID-19 federal flexibilities enabled telehealth for buprenorphine initiation for opioid use disorder (OUD).
• Limited data exists comparing telehealth and in-person buprenorphine initiation.
• Understanding correlates of telehealth initiation is crucial for post-pandemic policy.

Purpose of the Study:

• To examine correlates of telehealth versus in-person buprenorphine initiation among adults with OUD.
• To identify patient and provider characteristics associated with telehealth initiation.
• To inform policies regarding telehealth access for OUD treatment.

Main Methods:

• Retrospective, cross-sectional analysis of the Integrated Humana Medical and Pharmacy dataset.
• Included adults with newly diagnosed OUD initiating buprenorphine between March 2020 and December 2023.
• Used LASSO-penalized logistic regression to identify correlates of telehealth initiation.

Main Results:

• 18.5% (748/4034) of patients initiated buprenorphine via telehealth.
• Telehealth initiation was associated with younger age, prior telehealth use, cannabis/sedative use disorders, psychiatric providers, and fewer comorbidities.
• Rural patients were more likely to initiate via telehealth compared to suburban and urban patients.

Conclusions:

• Telehealth is a significant modality for buprenorphine initiation, utilized by approximately 1 in 5 patients.
• Variations in telehealth initiation by age, geography, and patient characteristics highlight diverse needs.
• Policies should support continued telehealth access while ensuring robust in-person options for OUD treatment.