Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas
Background: In March 2020, policy changes by the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration aimed to maintain access to office-based opioid treatment services by easing telehealth buprenorphine prescribing restrictions. However, the effectivenes...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-03-01
|
| Series: | Drug and Alcohol Dependence Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724624000064 |
| _version_ | 1797249085183361024 |
|---|---|
| author | Whanhui Chi Chijioke Okeke Douglas Thornton Hua Chen Abofazl Sadeghi Tyler J. Varisco |
| author_facet | Whanhui Chi Chijioke Okeke Douglas Thornton Hua Chen Abofazl Sadeghi Tyler J. Varisco |
| author_sort | Whanhui Chi |
| collection | DOAJ |
| description | Background: In March 2020, policy changes by the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration aimed to maintain access to office-based opioid treatment services by easing telehealth buprenorphine prescribing restrictions. However, the effectiveness of these changes remains largely unmeasured. The objective of this study was to measure the effectiveness of COVID-19-related telehealth flexibilities in an all-payer cohort from the Texas Prescription Monitoring Program. Methods: Using Texas Prescription Monitoring Program data, we identified oral buprenorphine and buprenorphine/naloxone prescriptions dispensed in Texas between September 1, 2019, and September 26, 2020. Weekly counts of prescriptions, prescribing physicians, and dispensing pharmacies were analyzed. An autoregressive integrated moving average (ARIMA) model estimated changes in prescription volume between pre-implementation (September 1, 2019 - February 15, 2020) and post-implementation (April 12, 2020 - September 26, 2020) periods. Results: Pre-flexibility, an average of 8898 (SD: 342) buprenorphine prescriptions were dispensed to 7829 (SD: 326) patients weekly. This declined to 8360 (SD: 247) prescriptions and 7661 (SD: 229) patients post-flexibility. Adjusted for seasonality, this represented a statistically significant average decline of −257.27 (95% CI: −426.06, −88.49) patients and −647.01 (95% CI: −856.67, −437.36) prescriptions per week. Discussion: Our results suggest a modest decline in buprenorphine dispensing volume early in the COVID-19 pandemic. While difficult to assess its significance, it can be assumed that telehealth flexibilities mitigated a potentially larger decline. Future research should explore system and individual-level barriers to telehealth utilization. |
| first_indexed | 2024-03-07T16:53:07Z |
| format | Article |
| id | doaj.art-7cc8dbc44a2b4c34b559b818b4fc27d4 |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-04-24T20:24:52Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-7cc8dbc44a2b4c34b559b818b4fc27d42024-03-22T05:41:19ZengElsevierDrug and Alcohol Dependence Reports2772-72462024-03-0110100222Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in TexasWhanhui Chi0Chijioke Okeke1Douglas Thornton2Hua Chen3Abofazl Sadeghi4Tyler J. Varisco5The Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USA; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USAThe Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USA; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USAThe Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USA; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USADepartment of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USA; Center for Population Health Outcomes and Pharmacoepidemiology Education and Research, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USADepartment of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USAThe Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USA; Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, 4349 Martin Luther King Blvd, Houston, TX 77204, USA; Correspondence to: The Prescription Drug Misuse Education and Research Center, Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, USA.Background: In March 2020, policy changes by the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration aimed to maintain access to office-based opioid treatment services by easing telehealth buprenorphine prescribing restrictions. However, the effectiveness of these changes remains largely unmeasured. The objective of this study was to measure the effectiveness of COVID-19-related telehealth flexibilities in an all-payer cohort from the Texas Prescription Monitoring Program. Methods: Using Texas Prescription Monitoring Program data, we identified oral buprenorphine and buprenorphine/naloxone prescriptions dispensed in Texas between September 1, 2019, and September 26, 2020. Weekly counts of prescriptions, prescribing physicians, and dispensing pharmacies were analyzed. An autoregressive integrated moving average (ARIMA) model estimated changes in prescription volume between pre-implementation (September 1, 2019 - February 15, 2020) and post-implementation (April 12, 2020 - September 26, 2020) periods. Results: Pre-flexibility, an average of 8898 (SD: 342) buprenorphine prescriptions were dispensed to 7829 (SD: 326) patients weekly. This declined to 8360 (SD: 247) prescriptions and 7661 (SD: 229) patients post-flexibility. Adjusted for seasonality, this represented a statistically significant average decline of −257.27 (95% CI: −426.06, −88.49) patients and −647.01 (95% CI: −856.67, −437.36) prescriptions per week. Discussion: Our results suggest a modest decline in buprenorphine dispensing volume early in the COVID-19 pandemic. While difficult to assess its significance, it can be assumed that telehealth flexibilities mitigated a potentially larger decline. Future research should explore system and individual-level barriers to telehealth utilization.http://www.sciencedirect.com/science/article/pii/S2772724624000064TelemedicineOpioid-Related DisordersPrescription Drug Monitoring ProgramsCOVID-19Opiate substitution treatmentInterrupted Time Series Analysis |
| spellingShingle | Whanhui Chi Chijioke Okeke Douglas Thornton Hua Chen Abofazl Sadeghi Tyler J. Varisco Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas Drug and Alcohol Dependence Reports Telemedicine Opioid-Related Disorders Prescription Drug Monitoring Programs COVID-19 Opiate substitution treatment Interrupted Time Series Analysis |
| title | Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas |
| title_full | Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas |
| title_fullStr | Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas |
| title_full_unstemmed | Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas |
| title_short | Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas |
| title_sort | leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities an interrupted time series analysis in texas |
| topic | Telemedicine Opioid-Related Disorders Prescription Drug Monitoring Programs COVID-19 Opiate substitution treatment Interrupted Time Series Analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2772724624000064 |
| work_keys_str_mv | AT whanhuichi leveragingprescriptionmonitoringprogramdatatoevaluatetheimplementationofbuprenorphinetelehealthflexibilitiesaninterruptedtimeseriesanalysisintexas AT chijiokeokeke leveragingprescriptionmonitoringprogramdatatoevaluatetheimplementationofbuprenorphinetelehealthflexibilitiesaninterruptedtimeseriesanalysisintexas AT douglasthornton leveragingprescriptionmonitoringprogramdatatoevaluatetheimplementationofbuprenorphinetelehealthflexibilitiesaninterruptedtimeseriesanalysisintexas AT huachen leveragingprescriptionmonitoringprogramdatatoevaluatetheimplementationofbuprenorphinetelehealthflexibilitiesaninterruptedtimeseriesanalysisintexas AT abofazlsadeghi leveragingprescriptionmonitoringprogramdatatoevaluatetheimplementationofbuprenorphinetelehealthflexibilitiesaninterruptedtimeseriesanalysisintexas AT tylerjvarisco leveragingprescriptionmonitoringprogramdatatoevaluatetheimplementationofbuprenorphinetelehealthflexibilitiesaninterruptedtimeseriesanalysisintexas |