Dela Cruz, Christine v. - Ebn

FAR EASTERN UNIVERSITY
Nicanor Reyes Street, Sampaloc, Manila

Institute of Health Sciences and Nursing
Second Semester, A.Y. 2022 – 2023
Submitted by: Christine V. Dela Cruz, 310-Group 2

Submitted to: Sir Edgar Manood
Date Submitted: May 12, 2023
EVIDENCED-BASED NURSING
1) General Question
- Are telemedicine-delivered treatment interventions effective for substance use disorders?
2) Reconstruction of General Question related to patient’s identified problem
- In patients with substance use disorder, is interventions based on telemedicine-delivered treatment effective in
managing and treating substance use disorders?
a) PICO
Patient Focus Intervention Comparison or Control Outcome

Population
Patients with substance Studies varied widely in Interventions delivered to This systematic review identified and
use disorder. Studies that complexity and patients with substance use summarized studies examining the
were included were interventions included. disorders (SUD) that includes effectiveness of telemedicine
required to examine real- Among the three studies the use of videoconferencing interventions to deliver treatment for
time videoconference- focusing on nicotine use which allows real time patients with substance use disorders
delivered medication or disorder, all encompassed communication between a which include videoconferencing-
psychotherapy psychoeducation and patient and a clinician at a delivered medication or psychotherapy
intervention to treat adults psychotherapy or counseling distant site. The selected treatments. Out of 841 manuscripts that
with SUDs. Given the components. Kim and studies included both met the search criteria, 13 studies met
limited research that has colleagues also provided individual and group-based the inclusion criteria. Studies covered
been published, the transdermal nicotine patches treatments. For studies that interventions for nicotine, alcohol and
researchers used broad to both study arms and included a comparison group, opioid use disorders. They varied
inclusion criteria to Richter and colleagues also the comparisons varied from widely in size, quality, and in the
include studies that were provided guidance to in-person delivered treatment, comparison groups examined. Studies
randomized, experimental, participants to help them phone-based treatment for two examined both delivery of
quasi-experimental or select and obtain nicotine studies and one study psychotherapy and medication
observational in design. pharmacotherapy for comparing to usual care that treatments. Most studies suggested
Single case reports or nicotine cessation. Among did not include a major telemedicine interventions were
commentaries that lacked the five studies focusing on treatment component. associated with high patient satisfaction
patient level data were risky alcohol use and alcohol Treatment intensity varied and are an effective alternative,
excluded. Studies must use disorders, all provided from two sessions over two especially when access to treatment is
have included either a psychotherapy, but no months (Baca & Manuel, otherwise limited.
comparison group or studies included any forms 2007) to ongoing treatment
measurements at multiple of medication treatment. visits for interventions Individuals with SUDs experience one
time points (i.e. at least Among the five studies involving medication of largest gaps between treatment need
baseline and a follow-up focusing on opioid use treatment for opioid use and treatment utilization, with only a
time point). The disorders, two focused on disorders. minority receiving treatment (Park-Lee
researchers included delivering psychotherapy to et al., 2017). Challenges with treatment
studies that addressed any individuals who were engagement and treatment access
SUD, including nicotine receiving usual in-person contribute to this gap. Telemedicine has
use disorder. The treatment with methadone been shown to be a promising approach
outcomes of interest maintenance. The remaining to expanding reach and access to mental
included substance use, three non-randomized health and other chronic disease
treatment adherence, studies examined use of treatment. In this review, the researchers
acceptability of the videoconference-delivered systematically examined literature on
intervention, and medication treatment, interventions delivering SUD treatment
satisfaction with primarily buprenorphine and via synchronous videoconference that
treatment. methadone, delivered within assessed clinical impacts on substance
an outpatient treatment use, treatment retention and
setting. Treatment acceptability and feasibility. They
encompassed visits with a categorized interventions by substances
patient located at a rural that were targeted, including nicotine,
clinic and a physician at a alcohol, and opioids. However, they did
distant site and included not find telemedicine interventions for
other components such as other SUDs including cannabis and
urine toxicology screens. stimulant use disorders. Through this
review, the researchers find that
telemedicine interventions delivering
treatment for SUDs are promising,
especially when treatments are less
available otherwise, but data from
studies to date are limited and additional
studies are critically needed.
3) Critical Review with Summary or the Literature and Conclusion
It's critical that therapies are not only efficient but also readily available to patients given the growing harmful effects of
drug use disorders, including opioid use disorders, in the US. It has been demonstrated that using telemedicine, more specifically
the use of videoconferencing, which enables in-person interaction between a patient and a clinician at a different location, is an
efficient strategy for expanding access to treatments for mental health disorders and other chronic illnesses. The research
assessing the efficacy of telemedicine interventions to provide therapy for individuals with drug use disorders were selected and
analyzed in this systematic review.
Thirteen studies out of 841 publications that matched the search criteria were eligible for inclusion. Interventions for
alcohol, opioid, and nicotine use disorders were studied. They were substantially distinct in terms of size, quality, and the
comparison groups looked at. Studies looked at how psychotherapy and drugs were administered. The majority of research
indicated that telemedicine interventions are an effective option, particularly when access to therapy is otherwise constrained,
and are linked with high patient satisfaction. The studies done thus far, however, had significant methodological shortcomings.
For individuals with drug use disorders, further research is required, such as larger size randomized trials that look at various
telemedicine models that may be incorporated into current healthcare delivery settings.
In conclusion, the increase in overdose and other serious consequences for patients with SUDs and the near ubiquitous
challenges with access to effective treatment underscores the pressing need to develop models that can increase treatment reach
and access. Telemedicine treatment interventions are promising not only in terms of effectiveness but are also likely quite feasible
given the technology in place and the rapid growth in telemedicine across healthcare. However, additional studies are also
critically needed, addressing the methodological limitations of studies to date, to lead to telemedicine interventions that will be
effective and utilized by patients with SUDs.
4) Reference
▪ Lin, L. (Allison), Casteel, D., Shigekawa, E., Weyrich, M. S., Roby, D. H., & McMenamin, S. B. (2019). Telemedicine-
delivered treatment interventions for substance use disorders: A systematic review. Journal of Substance Abuse
Treatment, 101, 38–49. https://doi.org/10.1016/j.jsat.2019.03.007

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FAR EASTERN UNIVERSITY

Nicanor Reyes Street, Sampaloc, Manila

Submitted by: Christine V. Dela Cruz, 310-Group 2

Patient Focus Intervention Comparison or Control Outcome

3) Critical Review with Summary or the Literature and Conclusion

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