Effects of Telehealth on Dropout and Retention in Care among Treatment-Seeking Individuals with Substance Use Disorder: A Retrospective Cohort Study

Background: During the COVID-19 pandemic, telehealth became a widely used method of delivering treatment for substance use disorders (SUD), but its impact upon treatment engagement and dropout remains unknown. Methods: We conducted a retrospective analysis of adult SUD patients (n = 544) between Oct...

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Bibliographic Details
Published in:Substance use & misuse 2023, Vol.58 (4), p.481-490
Main Authors: Gainer, Danielle M., Wong, Celeste, Embree, Jared A., Sardesh, Nina, Amin, Amna, Lester, Natalie
Format: Article
Language:English
Subjects:
Adult
Cohort analysis
COVID-19
dropout
Dropping out
Drug use
Health behavior
Health facilities
Health services utilization
Help seeking behavior
Humans
Medical diagnosis
Medical treatment
Pandemics
Patients
Retention in Care
Retrospective Studies
Services
Substance abuse
Substance abuse treatment
Substance use disorder
substance use disorders
Substance-Related Disorders - therapy
Telehealth
Telemedicine
Treatment programs
treatment retention
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Summary:Background: During the COVID-19 pandemic, telehealth became a widely used method of delivering treatment for substance use disorders (SUD), but its impact upon treatment engagement and dropout remains unknown. Methods: We conducted a retrospective analysis of adult SUD patients (n = 544) between October 2020 and June 2022 among a cohort of treatment-seeking patients at a nonprofit community behavioral health center in Southwestern Ohio. We estimated the likelihood of treatment dropout using survival curves and Cox proportional hazard models, comparing patients who used telehealth with video, telephone, or solely in-person services within the first 14 days of diagnosis. We also compared the likelihood of early treatment engagement. Results: Patients who received services through telehealth with video in the initial 14 days of diagnosis had a lower hazard of dropout, compared to patients receiving solely in-person services (0.64, 95% CI [0.46, 0.90]), while there was no difference in hazards of dropout between patients who received telephone and in-person services. Early use of telehealth, both via video (5.40, 95% CI [1.92, 15.20]) and telephone (2.12, 95% CI [1.05, 4.28]), was associated with greater odds of treatment engagement compared to in-person care. Conclusion: This study adds to the existing literature related to telehealth utilization and engagement in care and supports the inclusion of telehealth in SUD treatment programs for treatment-seeking individuals.
ISSN:1082-6084
1532-2491
DOI:10.1080/10826084.2023.2167496