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Individuals struggling with OUD face many barriers that impede access to care, including stigma, the availability of trained clinicians, and costs associated with treatment. OAT has been found to be one of the most effective treatments for OUD. Therapies like these have shown improvements in clients’ psychosocial functioning associated with longer periods in treatment. OAT (e.g., methadone or buprenorphine) is a treatment for individuals with OUDs involving the use of opioid agonists (full and partial) in place of higher risk opioids with the goal of maintenance and stabilization. Typical treatment includes pharmacological and psychosocial interventions to reduce drug use while improving psychosocial outcomes. Opioid use disorder (OUD) is a chronic health condition that requires long-term supportive treatment. Western Canada has been the most significantly impacted region of the country, but numbers have risen in other areas. In Canada, more than 16,364 apparent opioid-related deaths were documented between January 2016 and March 2020.
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The misuse of opioids including illicit fentanyl has been escalating in Canada and North America for more than ten years, and negative health effects continue to be reported. Entirely virtual delivery of opioid agonist therapy is a promising option to facilitate access to evidence based treatment for opioid use disorder (OUD) in the context of a fentanyl overdose crisis, particularly for individuals living in rural or underserved areas. The VODP model demonstrated high levels of client satisfaction, rapid growth in utilization and positive preliminary clinical outcomes. Clients reported high levels of satisfaction (90%) and outcomes reflected reductions in drug use and overdose as well as improved social functioning. Treatment retention rates for clients in ongoing care were comparable to published reports, with 90% of the study sample remaining in treatment over 6 months, and 58% showing retention over 12 months.
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Despite rapid growth in utilization, median wait days for treatment decreased from 6 to 0 days with the initiation of a Same Day Start service to support low barrier immediate access to treatment.
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Descriptive analysis showed rapid growth in utilization over three fiscal years. ResultsĪ total of 440 client records were included in the study sample. Data regarding clinical outcomes for clients engaged in ongoing care with the VODP were aggregated for analysis over four time periods, including treatment retention rates at 6 and 12 months. Utilization trends over three years were analyzed, including admissions, discharges and active client information. Outcome data were extracted at admission to ongoing care by Case Management within the VODP and at 3, 6 and 12 months for the duration of treatment. MethodsĪ retrospective chart review was conducted using datasets within existing electronic health records and databases from Alberta’s Virtual Opioid Dependency Program (VODP). This paper introduces the unique virtual clinic model and describes outcomes from that model. A completely virtual model of care has been developed in Alberta, Canada. Barriers to accessing OAT such as lack of transportation, in-person induction requirements, employment demands and limited childcare options reduce treatment opportunities for clients. Virtually delivered healthcare (telehealth, telemedicine) has the potential to reduce gaps in access to opioid agonist therapy (OAT).
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