Telemedicine use for treatment of opioid use disorder and other comorbidities during Covid-19: A case study

Abstract

The objective of this report is to highlight the positive impact of the recent rapid integration of telemedicine (TM) into BC’s existing healthcare framework, particularly its effect on a special population in a time of crisis, currently the COVID-19 pandemic. We interviewed a 51-year-old male treated at Crosstown Clinic, a local community substance use clinic for opiate use disorder (OUD), where he receives daily injectable opiate agonist therapy (iOAT). Through an interdisciplinary approach, this clinic also manages his co-morbidities, including multiple sclerosis (MS) and Hepatitis C (HCV). During the current global pandemic, he presented with several days of diplopia, which prompted an urgent TM appointment with neuro-ophthalmology. A virtual physical exam was conducted, high dose oral prednisone was prescribed, and the patient sent for imaging, resulting in timely diagnosis and management of an MS flair. The patient described multiple advantages of TM compared to in-person visits, such as the greater flexibility in arranging appointment times, and similar levels of quality in physician assessment and care. Research into TM also demonstrates that it decreases the transmission of disease that can be associated with in person visits, decreasing financial and opportunity cost to patients, and providing similar health outcomes compared to in-person visits for patients undergoing treatments for substance use, HCV, or MS. The current global circumstances surrounding COVID-19 have dramatically increased the use of TM services and have paved the way for telemedical services to remain an integral tool in the use of healthcare services, particularly for special populations.