Hser, YI., Ober, A.J., Dopp, A.R. et al. Is telemedicine the answer to rural expansion of medication treatment for opioid use disorder? Early experiences in the feasibility study phase of a National Drug Abuse Treatment Clinical Trials Network Trial. Addict Sci Clin Pract 16, 24 (2021). https://doi.org/10.1186/s13722-021-00233-x
A randomized controlled trial aims to test the implementation and effectiveness of adding telemedicine-based medication treatment for opioid use disorder in rural primary care. In preparation, researchers conducted a feasibility study to develop and pilot test implementation procedures. The researchers shared the challenges and lessons learned from the first two months of the six-month feasibility study. During the first two months, the study team visited and recruited potential study clinics. With the selected clinics, regular quality assurance meetings were conducted with different staff members, care coordinator assigned to facilitate the study and information technology staff. The study also partnered with a telemedicine vendor to work with clinics on referrals and provide services as needed. 7 rural primary care centers in Maine, Washington, and Idaho participated in the feasibility study. The clinics completed all training on study protocols, data safety, ethics and preparation tasks in eight months. The study identified many challenges, including low rates of identification of new patients with opioid use disorder through screening, low rates of referral to telemedicine, internet access issues, and insurance coverage.