In-Person Versus Telehealth Setting for the Delivery of Substance Use Disorder Treatment: Ecologically Valid Comparison Study

• Type of Material: Article
• Authors: Quyen M Ngo, Hazelden Betty Ford Foundation; Jacqueline E Braughton, Hazelden Betty Ford Foundation; Kate Gliske, Hazelden Betty Ford Foundation; Lance Waller, Emory University; Siara Sitar, Emory University School of Medicine; Danielle N Kretman, Hazelden Betty Ford Foundation; Hannah Cooper, Emory University; Justine Welsh, Emory University
• Language: English
• Date: 2022-04-01
• Publisher: JMIR Publications
• Publication Version: Final Published Version
• Copyright Statement: ©Quyen M Ngo, Jacqueline E Braughton, Kate Gliske, Lance A Waller, Siara Sitar, Danielle N Kretman, Hannah L F Cooper, Justine W Welsh. Originally published in JMIR Formative Research (https://formative.jmir.org), 04.04.2022.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/34408
• Title of Journal or Parent Work: JMIR Formative Research
• Volume: 6
• Issue: 4
• Start Page: e34408
• End Page: e34408
• Keywords: substance use treatment; patient outcomes; telehealth
• Research Categories: Health Sciences, Public Health; Psychology, Behavioral; Biology, Biostatistics

Abstract

Background: The COVID-19 pandemic has profoundly transformed substance use disorder (SUD) treatment in the United States, with many web-based treatment services being used for this purpose. However, little is known about the long-term treatment effectiveness of SUD interventions delivered through digital technologies compared with in-person treatment, and even less is known about how patients, clinicians, and clinical characteristics may predict treatment outcomes. Objective: This study aims to analyze baseline differences in patient demographics and clinical characteristics across traditional and telehealth settings in a sample of participants (N=3642) who received intensive outpatient program (IOP) substance use treatment from January 2020 to March 2021. Methods: The virtual IOP (VIOP) study is a prospective longitudinal cohort design that follows adult (aged ≥18 years) patients who were discharged from IOP care for alcohol and substance use–related treatment at a large national SUD treatment provider between January 2020 and March 2021. Data were collected at baseline and up to 1 year after discharge from both in-person and VIOP services through phone- and web-based surveys to assess recent substance use and general functioning across several domains. Results: Initial baseline descriptive data were collected on patient demographics and clinical inventories. No differences in IOP setting were detected by race (χ22=0.1; P=.96), ethnicity (χ22=0.8; P=.66), employment status (χ22=2.5; P=.29), education level (χ24=7.9; P=.10), or whether participants presented with multiple SUDs (χ28=11.4; P=.18). Significant differences emerged for biological sex (χ22=8.5; P=.05), age (χ26=26.8; P<.001), marital status (χ24=20.5; P<.001), length of stay (F2,3639=148.67; P<.001), and discharge against staff advice (χ22=10.6; P<.01). More differences emerged by developmental stage, with emerging adults more likely to be women (χ23=40.5; P<.001), non-White (χ23=15.8; P<.001), have multiple SUDs (χ23=453.6; P<.001), have longer lengths of stay (F3,3638=13.51; P<.001), and more likely to be discharged against staff advice (χ23=13.3; P<.01). Conclusions: The findings aim to deepen our understanding of SUD treatment efficacy across traditional and telehealth settings and its associated correlates and predictors of patient-centered outcomes. The results of this study will inform the effective development of data-driven benchmarks and protocols for routine outcome data practices in treatment settings.