Association between different modalities of opioid use disorder-related care delivery and opioid use disorder-related patient outcomes: A retrospective cohort study

Nahiyan Bin Noor; George Pro; Mahip Acharya; Hari Eswaran; Corey J Hayes

doi:10.1016/j.abrep.2025.100588

Association between different modalities of opioid use disorder-related care delivery and opioid use disorder-related patient outcomes: A retrospective cohort study

Addict Behav Rep. 2025 Feb 2:21:100588. doi: 10.1016/j.abrep.2025.100588. eCollection 2025 Jun.

Authors

Nahiyan Bin Noor¹, George Pro², Mahip Acharya^{1

3}, Hari Eswaran^{1

3}, Corey J Hayes^{1

4

5

6}

Affiliations

¹ Institute for Digital Health & Innovation, University of Arkansas for Medical Sciences Little Rock AR USA.
² Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences Little Rock AR USA.
³ Department of Obstetrics and Gynecology, College of Medicine, University of Arkansas for Medical Sciences Little Rock AR USA.
⁴ Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences Little Rock AR USA.
⁵ Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock AR USA.
⁶ Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences Little Rock AR USA.

Abstract

Objective: This study assessed the impact of different modalities of delivery of opioid use disorder (OUD)-related care on several patient outcomes.

Methods: This study was conducted among patients newly diagnosed with OUD and receiving OUD-related care between March 2020 and March 2022, using data from Epic Cosmos. We examined the association between the most common modality of OUD-related care delivery (audio-only vs. audiovisual vs. in-person) and the number of emergency department (ED) visits for any overdose and opioid-specific overdose and receipt of medication treatment for OUD (MOUD; primary). We also examined the association between the most common modality of OUD-related care delivery and all-cause ED visits, hospitalizations, and psychiatric-related hospitalizations (secondary outcomes). We estimated logistic regression for receipt of MOUD and negative binomial for all other outcomes.

Results: Most patients primarily received OUD-related care in person (87.6 %, n = 159,351), followed by audiovisual visits (11.3 %, n = 20,629) and audio-only visits (1.1 %, n = 1,869). The mean (SD) ages for these groups were 51.7 (15.9), 47.1 (15.0), and 51.1 (15.8) years, respectively. Compared to receiving OUD-related care primarily in-person, receiving care predominantly through audio-only or audiovisual visits was associated with a modest decrease in number of all-cause ED visits. Receiving OUD-related care primarily through audiovisual visits, compared to in-person care, was associated with a slight increase in the odds of receiving MOUD. No statistically significant differences were found between the care delivery modalities and the other outcomes we examined.

Conclusion: Telehealth, delivered via audio-only or audiovisual methods, appears to provide care of similar quality to in-person OUD care and may modestly reduce OUD-related ED visits while slightly increasing MOUD receipt. These findings support continued delivery of OUD-related care through telehealth and continuation of COVID-19-related policies.

Keywords: Audio; Audiovisual; In-person; Medication for Opioid Use Disorder (MOUD); Opioid Overdose; Opioid Use Disorder; Telehealth.