During the COVID pandemic video telehealth was “forced” into the mainstream of healthcare delivery. Now that many patients have become familiar and comfortable with telehealth as a mode of healthcare delivery it is reasonable to begin to evaluate the effectiveness of telehealth.
Telehealth provides a low overhead (compared to traditional in person visits) health delivery option for both patients and providers, one of the areas of application are patient coaching and follow-up. Both patient coaching and follow-up are elements of supporting patients with regard to medication adherence. Thus a reasonable question to ask is – Can telehealth enhance medication adherence?
Recently Vakkalanka, et. al. sought to answer this question for patients using buprenorphine for opioid use disorder (OUD) – Telehealth Utilization Is Associated with Lower Risk of Discontinuation of Buprenorphine: a Retrospective Cohort Study of US Veterans – published in the Journal of General Internal Medicine. This study evaluated the time to discontinuation of buprenorphine treatment. The study patients managed with telehealth versus traditional in-person visits. In addition, the study sought to understand if the effect of telehealth differed in rural versus urban areas. The telehealth evaluation was designed as a retrospective cohort study of Veterans diagnosed with OUD and treated with buprenorphine. All Veterans Health Administration (VHA) facilities were included and the evaluation period extended from 2008 and 2017. The final study sample included 28,791 patients. Buprenorphine discontinuation – the primary outcome – was defined as treatment discontinuation greater than 14 days of absence during a 1 year evaluation period. When compared to traditional in-person encounters, buprenorphine discontinuation was lower for telehealth (aHR: 0.69; 95%CI: 0.60, 0.78). The authors found no evidence that the effect differed if the patient was located in a rural or urban area.
While telehealth based adherence coaching needs to be evaluated with different disease states and different patient populations the results of this study appear promising.
At CSSHealth we believe that telehealth tools will become a key component of managing patient medication use behaviors such as adherence. To that end, we have incorporated a complete telehealth module into the MTMPath medication management platform.
If you have an interest in incorporating telehealth into your medication management program please don’t hesitate to reach out.
Jim Notaro, RPh, PhD
Chief Clinical Officer and Founder