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Pandemic-Related Buprenorphine Prescribing Changes Linked With Improved Outcomes
Changes to buprenorphine prescribing guidelines, enacted in response to the COVID-19 pandemic, were found to have improved opioid use disorder (OUD) patient outcomes, according to researchers from Dornsife School of Public Health at Drexel University.
The Drexel researchers reviewed data from medical records and Pennsylvania’s prescription drug monitoring program (PDMP) for 506 patients being treated at Prevention Point Philadelphia, a multiservice harm reduction organization, from September 2018 to June 2020. Their findings were published in the journal Drug and Alcohol Dependence Reports.
Early in the pandemic, the Drug Enforcement Agency (DEA) loosened buprenorphine prescribing regulations, including the allowance of longer prescriptions, fewer drug screening requirements during treatment, and the use of telehealth-based visits. Researchers found that clients who used telehealth-based resources at Prevention Point stayed in treatment for an average of 78 days. Those who accessed their caregivers offsite through telehealth platforms stayed in treatment for 180 days on average.
These findings translate to a treatment duration 3 to 8 times greater than those treated before the onset of COVID-19. Pre-pandemic, nearly 1 in 7 OUD patients in the US remained on buprenorphine for at least 180 days, noted study co-author Benjamin Cocchiaro, MD, a family medicine provider at Prevention Point.
“We treated the policy changes as a natural experiment and compared treatment outcomes before and after they took effect,” study lead author Kathleen Ward, a doctoral research fellow at the Dornsife School of Public Health’s Urban Health Collaborative, said in a news release. “We found the lessened restrictions were associated with people remaining in care for a longer period of time. This is a really important finding in support of these policy changes.”
A byproduct of loosening buprenorphine prescribing regulations was that the increased autonomy the changes allowed OUD patients in recovery helped foster a greater level of trust with their providers, Cocchiaro said in the release.
“Trust builds recovery,” Cocchiaro said. “The moment you decide for the patient what their recovery needs to look like, that’s when you start losing people. The decreased restrictions that came with the pandemic gave us just a taste of what low-barrier access to treatment looks like—we’re not even scratching the surface.”
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