PCORI has identified COVID-19 as an important research topic. Patients, clinicians, and others want to learn: What are effective ways to prevent or reduce the impact of COVID-19, especially on vulnerable populations and the healthcare workforce? To help answer this question, PCORI launched an initiative in 2020 to Strengthen Understanding of COVID-19 Impact and Inform Healthcare Responses. The initiative funded this research project and others.

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Opioid use disorder, or OUD, is a pattern of using opioids, such as prescription pain medicines or heroin, that can lead to addiction or overdose. An effective treatment for patients with OUD is medication-assisted treatment, or MAT. With MAT, patients take medicines that reduce cravings and withdrawal symptoms and help prevent overdose. Because MAT can lead to misuse or addiction, federal rules govern use of these medicines. Many of the rules require patients to get MAT in person. For example, to start MAT, patients must meet with their doctors. Patients must also go to the clinic each day to receive treatment.

The COVID-19 pandemic made it hard to get MAT in person. As a result, the rules were changed to make it easier for patients to receive MAT. For example, patients could start MAT during a telehealth visit. Telehealth provides care to patients remotely using phone, video, or other devices that can help manage care. Patients could also receive enough medicine to last several days so that they could take medicines at home instead of going to the clinic every day.

In this study, the research team is looking at how the federal rule changes affected access to MAT and health outcomes for patients with OUD.

Who can this research help?

Results may help policy makers decide if the new, less restrictive MAT rules should stay in place after the COVID-19 pandemic.

What is the research team doing?

The research team is reviewing health insurance claims and health records for patients with OUD. The team is looking to see if patients:

  • Filled MAT prescriptions
  • Got counseling
  • Stayed on treatment
  • Relapsed
  • Had an emergency room, or ER, visit
  • Died during the study

The research team is comparing these outcomes for patients with OUD before and during the COVID-19 pandemic. The team also wants to learn if other factors related to the pandemic, such as changes to clinic practices, might explain changes in treatment access more than the rule changes. Because treatment for alcohol use disorder, or AUD, doesn’t have strict rules like MAT, the team is comparing patients treated for OUD with patients treated for AUD.

Finally, the research team is interviewing patients receiving MAT, MAT providers, and policy makers about how well the federal rule changes worked for them and how COVID-19 affected them.

Patients with OUD are helping to plan and conduct the study.

Research methods at a glance

Design Elements Description
Design Quasi-experimental study
Population Claims and medical records data from an estimated 321,000 patients with OUD or AUD
  • OUD treatment from January to December 2019 under pre-pandemic federal MAT treatment guidelines
  • OUD treatment from April 2020 to March 2021 under revised federal MAT treatment guidelines (including flexible telehealth and video conferencing sessions with MAT prescribers and therapists, and take-home medicine supplies)
  • AUD treatment from January 2019 to March 2021

Primary: MAT prescription access and use; access to behavioral health providers (in person or via telehealth)

Secondary: ER visits, detoxification treatment utilization, treatment adherence, treatment retention, overdose, relapse, mortality

Timeframe 1-year follow-up for primary outcomes

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