Telehealth for the Treatment of OUD in Pregnant Patients

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CLINICAL CONVERSATIONS

A recent cohort study evaluated the treatment of opioid use disorder (OUD) and pregnancy outcomes in pregnant patients who were receiving treatment via a telemedicine addiction treatment program.¹

Psychiatric Times® sat down with lead investigator M. Justin Coffey, MD, DFAPA, FANPA, CHCIO, of Workit Health, to discuss the study’s results and their implications for the future of telehealth treatment for OUD.

Psychiatric Times: Your study data highlight that a significant portion of pregnant patients did not receive continuous OUD care throughout pregnancy. Can you discuss some of the barriers these individuals faced and how these might be addressed to improve continuity of care?

M. Justin Coffey, MD, DFAPA, FANPA, CHCIO: Individuals suffering from OUD face multiple barriers to care, including stigma, insufficient numbers of health providers offering evidence-based treatment, and inadequate insurance coverage and affordability.

On top of these barriers, individuals with OUD who are pregnant may also face criminal charges and loss of child custody. Evidence-based treatment for opioid use disorder is safe, effective, and associated with significant improvements in quality of life for both the mom and the baby.

PT: Notably, a number of patients transferred care to prenatal clinicians, although the majority continued with telehealth. What factors influenced this decision?

Coffey: Our approach involves shared decision-making, and many of our patients chose to continue receiving their care for OUD from their Workit Health providers. Those who transferred their opioid use disorder care to their prenatal provider did so for various practical or logistical reasons and with the collaborative support of their Workit Health providers.

PT: Can you elaborate on how telehealth was implemented within your program to deliver OUD care to pregnant patients? What specific aspects of telehealth delivery were crucial in ensuring accessibility and effectiveness of treatment for them?

Coffey: Our program is built on the concept of “patients as designers.” We bring the clinical science to individuals with lived experience and ask them how that evidence-based care could best be delivered.

That design thinking approach has led to innovations in our technology (such as automated urine drug screening), our clinical programming (such as treating highly comorbid conditions), and our delivery model (such as frictionless access). When we genuinely ask our patients what they want and need, they usually tell us everything we need to know.

PT: How do the study findings inform our understanding of the effectiveness and challenges of telehealth-delivered OUD care regarding pregnancy?

Coffey: Virtual-first approaches to providing evidence-based care to individuals with OUD can have powerful results. We hope the results published in our study compel others to embrace care redesign as an approach to serving vulnerable populations.

Dr Coffey is chief medical officer at Workit Health and a professor of psychiatry at Geisinger.

Reference

1. Coffey MJ, Weng M, Jimes C, et al. Telehealth treatment for opioid use disorder during pregnancy. JAMA Netw Open. 2024;7(3):e242463.

How do you identify, treat, and manage substance use disorders (SUDs) like OUD and addictive behaviors in your patients? Write to us at PTEditor@MMHGroup.com for a chance to be featured in our April content series on addiction and SUDs.