Patient Characteristics Associated with Phone Versus Video Telemedicine Visits for Substance Use Treatment during COVID-19

Objectives Although video visits may offer some benefits over the telephone, not all patients may be equipped to access video telemedicine, raising questions surrounding access disparities. The aim of this study is to examine patient characteristics associated with the use of phone versus video-enabled tele-medication for opioid use disorders (MOUD) during COVID-19. Methods This study uses data from a nonurban integrated substance use disorder treatment site in New York to examine patient characteristics associated with the modality of tele-MOUD care. The provider did not offer in-person care. Multivariable regression models were used to assess the association between patient's primary mode of tele-MOUD and patient demographic characteristics. Additional analysis of new patient inductions examined associations between mode of tele-MOUD induction and 30-day follow-up receipt. Results Of the 4557 tele-MOUD encounters, 76.92% were video and 23.08% were telephone visits. Older patients had significantly higher odds of primarily using telephone (odds ratio [OR]: 0.580; 95% confidence interval [CI]: 0.045, 1.115). Patients with higher education (OR: -0.791; 95% CI: -1.418, -0.168), recent overdose (OR: -0.40; 95% CI: -0.793, -0.010), and new patients (OR: 0.484; 95% CI: -0.945, 0.023) were significantly less likely to rely on telephone. Of 336 new patient initiations, 31 were conducted by telephone while 305 were conducted through video. The mode of new patient initiation was not associated with a follow-up visit within 30 days of initiation. Conclusions Telemedicine may increase access to MOUD, though certain patients may rely on different forms of telemedicine. Attention must be paid to policies that promote equitable access to both video and telephone tele-MOUD visits.