The impact of COVID-19 on trends in alcohol use disorder treatment in Veterans Health Administration
dc.contributor.author | Perumalswami, Ponni V. | |
dc.contributor.author | Kilpatrick, Sidonie | |
dc.contributor.author | Frost, Madeline C. | |
dc.contributor.author | Adams, Megan A. | |
dc.contributor.author | Kim, Hyungjin Myra | |
dc.contributor.author | Zhang, Lan | |
dc.contributor.author | Lin, Lewei | |
dc.date.accessioned | 2023-06-01T20:49:37Z | |
dc.date.available | 2024-07-01 16:49:36 | en |
dc.date.available | 2023-06-01T20:49:37Z | |
dc.date.issued | 2023-06 | |
dc.identifier.citation | Perumalswami, Ponni V.; Kilpatrick, Sidonie; Frost, Madeline C.; Adams, Megan A.; Kim, Hyungjin Myra; Zhang, Lan; Lin, Lewei (2023). "The impact of COVID-19 on trends in alcohol use disorder treatment in Veterans Health Administration." Addiction 118(6): 1062-1071. | |
dc.identifier.issn | 0965-2140 | |
dc.identifier.issn | 1360-0443 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/176847 | |
dc.description.abstract | Background and AimsThe COVID-19 pandemic disrupted health-care provision in the United States and prompted increases in telehealth-delivery of care. This study measured alcohol use disorder (AUD) treatment trends across visit modalities before and during COVID-19.Design, Setting, Participants and MeasurementsWe conducted a national, retrospective cohort study with interrupted time-series models to estimate the impact of COVID-19 on AUD treatment in the Veterans Health Administration (VHA) in the United States during pre-COVID-19 (March 2019 to February 2020) and COVID-19 (March 2020 to February 2021) periods. We analyzed monthly trends in telephone, video and in-person visits for AUD treatment and compared patient and treatment characteristics of patients receiving AUD treatment between the pre-COVID-19 and COVID-19 periods. AUD was defined using International Classification of Diseases, 10th revision (ICD-10) codes for alcohol abuse (F10.1) and alcohol dependence (F10.2), which have previously been used to study AUD in VHA.FindingsThe predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the beginning of the pre-COVID period was 13.8% (n = 49 494). The predicted percentage decreased by 4.3% (P = 0.001) immediately at the start of the COVID-19 period due to a decline in AUD psychotherapy. Despite an increase of 0.3% per month (P = 0.026) following the start of COVID-19, the predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the end of the study period remained below the pre-COVID-19 period. In February 2021, AUD psychotherapy visits were primarily delivered by video (50%, 58 748), followed by in-person (36.6%, 43 251) and telephone (13.8%, 16 299), while AUD pharmacotherapy visits were delivered by telephone (38.9%, 3623) followed by in-person (34.3%, 3193) and video (26.8%, 2498) modalities. Characteristics of VHA patients receiving AUD treatment were largely similar between pre-COVID-19 and COVID-19 periods.ConclusionsDespite increased telehealth use, the percentage of United States Veterans Health Administration patients with an alcohol use disorder (AUD) diagnosis receiving AUD treatment declined during COVID-19 (March 2020 to February 2021) mainly due to a decrease in psychotherapy. | |
dc.publisher | Wiley Periodicals, Inc. | |
dc.publisher | Department of Veterans Affairs | |
dc.subject.other | telehealth | |
dc.subject.other | Alcohol use disorder | |
dc.subject.other | COVID-19 | |
dc.subject.other | substance use disorders | |
dc.subject.other | telemedicine | |
dc.subject.other | veterans | |
dc.title | The impact of COVID-19 on trends in alcohol use disorder treatment in Veterans Health Administration | |
dc.type | Article | |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Public Health | |
dc.subject.hlbsecondlevel | Psychiatry | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/176847/1/add16156_am.pdf | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/176847/2/add16156.pdf | |
dc.identifier.doi | 10.1111/add.16156 | |
dc.identifier.source | Addiction | |
dc.identifier.citedreference | Osenbach JE, O’Brien KM, Mishkind M, Smolenski DJ. Synchronous telehealth technologies in psychotherapy for depression: a meta-analysis. Depress Anxiety. 2013; 30: 1058 – 67. | |
dc.identifier.citedreference | Harris AH, Oliva E, Bowe T, Humphreys KN, Kivlahan DR, Trafton JA. Pharmacotherapy of alcohol use disorders by the Veterans Health Administration: patterns of receipt and persistence. Psychiatr Serv. 2012; 63: 679 – 85. | |
dc.identifier.citedreference | Williams EC, Lapham GT, Shortreed SM, Rubinsky AD, Bobb JF, Bensley KM, et al. Among patients with unhealthy alcohol use, those with HIV are less likely than those without to receive evidence-based alcohol-related care: a national VA study. Drug Alcohol Depend. 2017; 174: 113 – 20. | |
dc.identifier.citedreference | Guidelines. VDCP. Management of Substance Use Disorder (SUD) ( 2021 ). Available at: https://www.healthquality.va.gov/guidelines/MH/sud/2021. Accessed November 1, 2022. | |
dc.identifier.citedreference | Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014; 311: 1889 – 900. | |
dc.identifier.citedreference | Reus VI, Fochtmann LJ, Bukstein O, Eyler AE, Hilty DM, Horvitz-Lennon M, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018; 175: 86 – 90. | |
dc.identifier.citedreference | Mekonen T, Chan GCK, Connor J, Hall W, Hides L, Leung J. Treatment rates for alcohol use disorders: a systematic review and meta-analysis. Addiction. 2021; 116: 2617 – 34. | |
dc.identifier.citedreference | Venegas A, Donato S, Meredith LR, Ray LA. Understanding low treatment seeking rates for alcohol use disorder: a narrative review of the literature and opportunities for improvement. Am J Drug Alcohol Abuse. 2021; 47: 664 – 79. | |
dc.identifier.citedreference | Marton K, Kanas N. Telehealth modalities for group therapy: comparisons to in-person group therapy. Int J Group Psychother. 2016; 66: 145 – 50. | |
dc.identifier.citedreference | Sugarman DE, Busch AB, McHugh RK, Bogunovic OJ, Trinh CD, Weiss RD, et al. Patients’ perceptions of telehealth services for outpatient treatment of substance use disorders during the COVID-19 pandemic. Am J Addict. 2021; 30: 445 – 52. | |
dc.identifier.citedreference | Zalewski M, Walton CJ, Rizvi SL, White AW, Gamache Martin C, O’Brien JR, et al. Lessons learned conducting dialectical behavior therapy via telehealth in the age of COVID-19. Cogn Behav Pract. 2021; 28: 573 – 87. | |
dc.identifier.citedreference | Williams EC, Achtmeyer CE, Young JP, Berger D, Curran G, Bradley KA, et al. Barriers to and facilitators of alcohol use disorder pharmacotherapy in primary care: a qualitative study in five VA clinics. J Gen Intern Med. 2018; 33: 258 – 67. | |
dc.identifier.citedreference | Frost MC, Matson TE, Richards JE, Lee AK, Achtmeyer CE, Bradley KA, et al. Barriers and facilitators to changing drinking and receiving alcohol-related care: interviews with Veterans Health Administration primary care patients who indicated interest but did not enroll in an alcohol care management intervention trial. Subst Abuse. 2022; 43: 1197 – 206. | |
dc.identifier.citedreference | May C, Nielsen AS. Barriers to treatment for alcohol dependence. J Drug Alcohol Res. 2019; 8: 17. | |
dc.identifier.citedreference | Rosen CS, Morland LA, Glassman LH, Marx BP, Weaver K, Smith CA, et al. Virtual mental health care in the Veterans Health Administration’s immediate response to coronavirus disease-19. Am Psychol. 2021; 76: 26 – 38. | |
dc.identifier.citedreference | King VL, Brooner RK, Peirce JM, Kolodner K, Kidorf MS. A randomized trial of Web-based videoconferencing for substance abuse counseling. J Subst Abuse Treat. 2014; 46: 36 – 42. | |
dc.identifier.citedreference | Teeters JB, Lancaster CL, Brown DG, Back SE. Substance use disorders in military veterans: prevalence and treatment challenges. Subst Abuse Rehabil. 2017; 8: 69 – 77. | |
dc.identifier.citedreference | Der-Martirosian C, Chu K, Steers WN, Wyte-Lake T, Balut MD, Dobalian A, et al. Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic. BMC Prim Care. 2022; 23: 155. | |
dc.identifier.citedreference | Reddy A, Gunnink E, Deeds SA, Hagan SL, Heyworth L, Mattras TF, et al. A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration. Healthcare. 2020; 8: 100464. | |
dc.identifier.citedreference | Wray CM, Van Campen J, Hu J, Slightam C, Heyworth L, Zulman DM. Crossing the digital divide: a veteran affairs program to distribute video-enabled devices to patients in a supportive housing program. JAMIA Open. 2022; 5: ooac027. https://doi.org/10.1093/jamiaopen/ooac027 | |
dc.identifier.citedreference | Ferguson JM, Jacobs J, Yefimova M, Greene L, Heyworth L, Zulman DM. Virtual care expansion in the Veterans Health Administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization. J Am Med Inform Assoc. 2021; 28: 453 – 62. | |
dc.identifier.citedreference | Jacobs J, Ferguson JM, van Campen J, Yefimova M, Greene L, Heyworth L, et al. Organizational and external factors associated with video telehealth use in the Veterans Health Administration before and during the COVID-19 pandemic. Telemed J E Health. 2022; 28: 199 – 211. | |
dc.identifier.citedreference | Walker JR, Korte JE, McRae-Clark AL, Hartwell KJ. Adherence across FDA-approved medications for alcohol use disorder in a Veterans Administration population. J Stud Alcohol Drugs. 2019; 80: 572 – 7. | |
dc.identifier.citedreference | Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE III, Hoppe JA, et al. Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US. JAMA Intern Med. 2020; 180: 1328 – 33. | |
dc.identifier.citedreference | Friedman AB, Barfield D, David G, Diller T, Gunnarson C, Liu M, et al. Delayed emergencies: the composition and magnitude of non-respiratory emergency department visits during the COVID-19 pandemic. J Am Coll Emerg Physicians Open. 2021; 2: e12349. | |
dc.identifier.citedreference | Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol. 2020; 75: 2871 – 2. | |
dc.identifier.citedreference | Holland M, Burke J, Hulac S, Morris M, Bryskiewicz G, Goold A, et al. Excess cardiac arrest in the community during the COVID-19 pandemic. JACC Cardiovasc Interv. 2020; 13: 1968 – 9. | |
dc.identifier.citedreference | Huynh K. Reduced hospital admissions for ACS—more collateral damage from COVID-19. Nat Rev Cardiol. 2020; 17: 453. | |
dc.identifier.citedreference | Czeisler ME, Barrett CE, Siegel KR, Weaver MD, Czeisler CA, Rajaratnam SMW, et al. Health care access and use among adults with diabetes during the COVID-19 pandemic—United States, February-March 2021. Morb Mortal Wkly Rep. 2021; 70: 1597 – 602. | |
dc.identifier.citedreference | Patel SY, McCoy RG, Barnett ML, Shah ND, Mehrotra A. Diabetes care and glycemic control during the COVID-19 pandemic in the United States. JAMA Intern Med. 2021; 181: 1412 – 4. | |
dc.identifier.citedreference | Lin LA, Bonar EE, Zhang L, Girard R, Coughlin LN. Alcohol-involved overdose deaths in US veterans. Drug Alcohol Depend. 2022; 230: 109196. | |
dc.identifier.citedreference | Spillane S, Shiels MS, Best AF, Haozous EA, Withrow DR, Chen Y, et al. Trends in alcohol-induced deaths in the United States, 2000–2016. JAMA Netw Open. 2020; 3: e1921451. | |
dc.identifier.citedreference | White AM, Castle IP, Powell PA, Hingson RW, Koob GF. Alcohol-related deaths during the COVID-19 pandemic. JAMA. 2022; 327: 1704 – 6. | |
dc.identifier.citedreference | Yeo YH, He X, Ting PS, Zu J, Almario CV, Spiegel BMR, et al. Evaluation of trends in alcohol use disorder-related mortality in the US before and during the COVID-19 pandemic. JAMA Netw Open. 2022; 5: e2210259. | |
dc.identifier.citedreference | Capasso A, Jones AM, Ali SH, Foreman J, Tozan Y, DiClemente RJ. Increased alcohol use during the COVID-19 pandemic: the effect of mental health and age in a cross-sectional sample of social media users in the U.S. Prev Med. 2021; 145: 106422. | |
dc.identifier.citedreference | Grossman ER, Benjamin-Neelon SE, Sonnenschein S. Alcohol consumption during the COVID-19 pandemic: a cross-sectional survey of US adults. Int J Environ Res Public Health. 2020; 17: 9189. | |
dc.identifier.citedreference | White HR, Stevens AK, Hayes K, Jackson KM. Changes in alcohol consumption among college students due to COVID-19: effects of campus closure and residential change. J Stud Alcohol Drugs. 2020; 81: 725 – 30. | |
dc.identifier.citedreference | Pollard MS, Tucker JS, Green HD Jr. Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US. JAMA Netw Open. 2020; 3: e2022942. | |
dc.identifier.citedreference | Cholankeril G, Goli K, Rana A, Hernaez R, Podboy A, Jalal P, et al. Impact of COVID-19 pandemic on liver transplantation and alcohol-associated liver disease in the USA. Hepatology. 2021; 74: 3316 – 29. | |
dc.identifier.citedreference | Baum A, Schwartz MD. Admissions to veterans affairs hospitals for emergency conditions during the COVID-19 pandemic. JAMA. 2020; 324: 96 – 9. | |
dc.identifier.citedreference | Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al. Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020. Morb Mortal Wkly Rep. 2020; 69: 699 – 704. | |
dc.identifier.citedreference | Connolly SL, Stolzmann KL, Heyworth L, Weaver KR, Bauer MS, Miller CJ. Rapid increase in telemental health within the Department of Veterans Affairs during the COVID-19 pandemic. Telemed J E Health. 2021; 27: 454 – 8. | |
dc.identifier.citedreference | Huskamp HA, Busch AB, Uscher-Pines L, Barnett ML, Riedel L, Mehrotra A. Treatment of opioid use disorder among commercially insured patients in the context of the COVID-19 pandemic. JAMA. 2020; 324: 2440 – 2. | |
dc.identifier.citedreference | Lin LAZL, Kim HM, Frost MC. Impact of COVID-19 telehealth policy changes on buprenorphine treatment for opioid use disorder. Am J Psychiatry. 2022; 179: 740 – 7. | |
dc.identifier.citedreference | Baca CT, Manuel JK. Satisfaction with long-distance motivational interviewing for problem drinking. Addict Disord Treat. 2007; 6: 39 – 41. | |
dc.identifier.citedreference | Frueh BC, Henderson S, Myrick H. Telehealth service delivery for persons with alcoholism. J Telemed Telecare. 2005; 11: 372 – 5. | |
dc.identifier.citedreference | Staton-Tindall M, Havens JR, Webster JM, Leukefeld C. METelemedicine: a pilot study with rural alcohol users on community supervision. J Rural Health. 2014; 30: 422 – 32. | |
dc.identifier.citedreference | Tarp K, Bojesen AB, Mejldal A, Nielsen AS. Effectiveness of optional videoconferencing-based treatment of alcohol use disorders: randomized controlled trial. JMIR Ment Health. 2017; 4: e38. | |
dc.identifier.citedreference | Tarp K, Mejldal A, Nielsen AS. Patient satisfaction with videoconferencing-based treatment for alcohol use disorders. Addict Disord their Treat. 2017; 16: 70 – 9. | |
dc.identifier.citedreference | Lin LA, Casteel D, Shigekawa E, Weyrich MS, Roby DH, McMenamin SB. Telemedicine-delivered treatment interventions for substance use disorders: a systematic review. J Subst Abuse Treat. 2019; 101: 38 – 49. | |
dc.identifier.citedreference | Department of Veterans Affairs—Department of Defense. VA/DoD Clinical Practice Guidelines for the Management of Substance Use Disorders Washington, DC: Department of Veterans Affairs; 2021. | |
dc.identifier.citedreference | Lapham GT, Rubinsky AD, Shortreed SM, Hawkins EJ, Richards J, Williams EC, et al. Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients. Drug Alcohol Depend. 2015; 153: 159 – 66. | |
dc.identifier.citedreference | Williams EC, Chen JA, Frost MC, Rubinsky AD, Edmonds AT, Glass JE, et al. Receipt of evidence-based alcohol-related care in a national sample of transgender patients with unhealthy alcohol use: overall and relative to non-transgender patients. J Subst Abuse Treat. 2021; 131: 108565. | |
dc.identifier.citedreference | M. S. Overview of VA Data, Information Systems, National Databases and Research Uses. 2017 [updated October 2, 2022]. Available at: https://www-hsrd-research-va-gov.proxy.lib.umich.edu/for_researchers/cyber_seminars/archives/2376-notes.pdf. Accessed November 1, 2022. | |
dc.identifier.citedreference | von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61: 344 – 9. | |
dc.identifier.citedreference | Fletcher OV, Chen JA, van Draanen J, Frost MC, Rubinsky AD, Blosnich JR, et al. Prevalence of social and economic stressors among transgender veterans with alcohol and other drug use disorders. SSM Popul Health. 2022; 19: 101153. | |
dc.identifier.citedreference | Williams EC, Fletcher OV, Frost MC, Harris AHS, Washington DL, Hoggatt KJ. Comparison of substance use disorder diagnosis rates from electronic health record data with substance use disorder prevalence rates reported in surveys across sociodemographic groups in the Veterans Health Administration. JAMA Netw Open. 2022; 5: e2219651. | |
dc.identifier.citedreference | McGinnis KA, Skanderson M, Edelman EJ, Gordon AJ, Korthuis PT, Oldfield B, et al. Impact of behavioral and medication treatment for alcohol use disorder on changes in HIV-related outcomes among patients with HIV: a longitudinal analysis. Drug Alcohol Depend. 2020; 217: 108272. | |
dc.identifier.citedreference | Lin LA, Fortney JC, Bohnert ASB, Coughlin LN, Zhang L, Piette JD. Comparing telemedicine to in-person buprenorphine treatment in U.S. veterans with opioid use disorder. J Subst Abuse Treat. 2022; 133: 108492. | |
dc.identifier.citedreference | Maynard C, Nelson K. Compensation for veterans with service connected disabilities: current findings and future implications. J Disabil Policy Stud. 2019; 31: 57 – 62. | |
dc.identifier.citedreference | Edens EL, Kasprow W, Tsai J, Rosenheck RA. Association of substance use and VA service-connected disability benefits with risk of homelessness among veterans. Am J Addict. 2011; 20: 412 – 9. | |
dc.identifier.citedreference | Economic Research Service. Rural–Urban Commuting Area Codes. 2010. [updated August 17, 2020]. Available at: https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes/. Accessed November 1, 2022. | |
dc.identifier.citedreference | Schoeneberger ML, Leukefeld CG, Hiller ML, Godlaski T. Substance abuse among rural and very rural drug users at treatment entry. Am J Drug Alcohol Abuse. 2006; 32: 87 – 110. | |
dc.identifier.citedreference | Centers for Medicare and Medicaid Services (CMS). Medicare telemedicine health care provider fact sheet [press release] Baltimore, MD: CMS; 2020. | |
dc.identifier.citedreference | Beard E, Marsden J, Brown J, Tombor I, Stapleton J, Michie S, et al. Understanding and using time-series analyses in addiction research. Addiction. 2019; 114: 1866 – 84. | |
dc.identifier.citedreference | Bernal JL, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2017; 46: 348 – 55. | |
dc.identifier.citedreference | Turner SL, Karahalios A, Forbes AB, Taljaard M, Grimshaw JM, Cheng AC, et al. Design characteristics and statistical methods used in interrupted time series studies evaluating public health interventions: a review. J Clin Epidemiol. 2020; 122: 1 – 11. | |
dc.identifier.citedreference | Cohen J. A power primer. Psychol Bull. 1992; 112: 155 – 9. | |
dc.identifier.citedreference | Sheskin DJ. Handbook of Parametric and Nonparametric Statistical Procedures 3rd ed. Boca Raton, FL: Chapman and Hall/CRC; 2003. | |
dc.working.doi | NO | en |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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