Use of a Telemedicine Bridge Clinic to Engage Patients in Opioid Use Disorder Treatment

Abstract

Objectives 

We aimed to assess the feasibility of using a telemedicine bridge clinic model as a low-barrier mechanism to initiate patients on medication treatment for opioid use disorder (MOUD) while facilitating engagement in long-term treatment.

Methods 

We established a telemedicine bridge clinic after the U.S. Drug Enforcement Administration temporarily suspended regulations limiting initial treatment of patients with buprenorphine via both audiovisual and audio-only technology during the COVID-19 public health emergency. The rate of engagement in medication treatment for opioid use disorder MOUD based upon review of the Prescription Drug Monitoring Program is described. Referral sources, technology utilization, and payer mix are also presented.

Results 

The Bridge Clinic scheduled 208 new patient visits and physicians evaluated 200, a show rate of 96% from April 2020 to July 2021. Of the 200 patients who were treated, 192 (96%) were diagnosed with opioid use disorder. Most patients (159/200, 79%) scheduled audio-only visits. At least 1 prescription for buprenorphine was filled by 185/192 (96%) of opioid use disorder patients within 30 days of the telemedicine visit and 147/192 (77%) of patients filled 2 or more prescriptions. Most patients were covered by Medicaid (62%) or were uninsured (19%). There was no significant difference in outcomes for patients evaluated by audio-only vs. audiovisual techniques.

Conclusion 

A Bridge Clinic using audiovisual and audio-only telemedicine served a high-risk, vulnerable population and facilitated engagement in evidence-based MOUD.