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Telehealth-Delivered Opioid Agonist Therapy for the Treatment of Adults with Opioid Use Disorder: Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Last updated: October 5, 2018
Project Number: RC1026-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical evidence regarding the use of telehealth-delivered opioid agonist therapy (alone or in combination with other approaches) in patients with opioid use disorder?
  2. What is the clinical evidence regarding the use of home-based, self-initiated opioid agonist therapy in patients with opioid use disorder?
  3. What is the cost-effectiveness of telehealth-opioid agonist therapy for patients with opioid use disorder?
  4. What is the cost-effectiveness of home based, self-initiated opioid agonist therapy for patients with opioid use disorder?
  5. What are the evidence-based guidelines regarding the use of telehealth or home-based opioid agonist therapy in patients with opioid use disorder?

Key Message

Limited evidence from one non-randomized retrospective study showed that after one year of treatment, those who participated in telehealth-delivered OAT were more likely to remain on uninterrupted OAT than those who received in-person OAT. The British Columbia Centre of Substance Abuse recommends that home-based, self-initiated OAT may be considered for those who have previous experience with OAT, or who have significant barriers to office attendance, while those who express significant apprehension of experiencing withdrawal, or those with concurrent alcohol and sedative use or misuse, are not likely to be good candidates for home induction. No relevant clinical studies regarding the use of home-based self-initiated therapy and no relevant cost-effectiveness studies regarding the use of telehealth or home-based self-initiated OAT were identified.