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Designing and Evaluating COVID Protocols for an Office-Based Opioid Treatment Program in an Urban Underserved Setting

David T. O’Gurek, MD, FAAFP

Corresponding Author: David T. O’Gurek, MD, FAAFP; Lewis Katz School of Medicine at Temple University. Email: david.ogurek@temple.edu

Section: Brief Report

| FULL PDF |

Background: Despite changing federal regulations for providing telehealth services and provision of controlled substances during the COVID-19 pandemic, there is little guidance available for office-based opioid treatment (OBOT) programs integrated in primary care settings. Purpose: 1) Develop disaster-preparedness protocols specific to the COVID-19 pandemic for an urban OBOT program, and 2) evaluate the impacts of the protocol and telehealth on care. Methods: Disaster-preparedness protocols specific to the COVID-19 pandemic were developed for an urban OBOT program, implemented on March 16, 2020. Retrospective chart review compared patients from January 1, 2020-March 13, 2020, to patients from March 16, 2020-April 30,2020, abstracting patient demographics and comparing show and no show rates between studied groups. Results: The disaster-preparedness protocol was developed under a deliberative process to address social issues of the urban underserved population. Of 852 visits conducted between Jan 1, 2020 and April 30, 2020, an 91.7% show rate (n=166/181) was documented for telemedicine visits after protocol implementation compared to a 74.1% show rate (n=497/671) for routine inperson care (p=0.06) without significant differences between the study populations. The no show rate was significantly lower after protocol implementation (8.3% vs 25.9%; p<0.05). Conclusions: OBOTs require organized workflows to continue to provide services during the COVID-19 pandemic. Telemedicine, in the face of relaxed federal regulations, has the  opportunity to enhance addiction care, creating a more convenient as well as an equally effective mechanism for OBOTs to deliver care that should inform future policy.

COVID-19 AHEAD OF PRINT

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