{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:26:07Z","timestamp":1791768367270,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Tracking changes in care utilization of medication for opioid use disorder (MOUD) services before, during, and after COVID\u201019\u2010associated changes in policy and service delivery in a mixed rural and micropolitan setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a retrospective, open\u2010cohort design, we examined visit data of MOUD patients at a family medicine clinic across three identified periods: pre\u2010COVID, COVID transition, and COVID. Outcome measures include the number and type of visits (in\u2010person or telehealth), the number of new patients entering treatment, and the number of urine drug screens performed. Distance from patient residence to clinic was calculated to assess access to care in rural areas. Goodness\u2010of\u2010Fit Chi\u2010Square tests and ANOVAs were used to identify differences between time periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Total MOUD visits increased during COVID (436 pre vs. 581 post, <jats:italic>p<\/jats:italic> &lt; 0.001), while overall new patient visits remained constant (33 pre vs. 29 post, <jats:italic>p<\/jats:italic> = 0.755). The clinic's overall catchment area increased in size, with new patients coming primarily from rural areas. Length of time between urine drug screens increased (21.1 days pre vs. 43.5 days post, <jats:italic>p<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The patterns of MOUD care utilization during this period demonstrate the effectiveness of telehealth in this area. Policy changes allowing for MOUD to be delivered via telehealth, waiving the need for in\u2010person initiation of MOUD, and increased Medicaid compensation for MOUD may play a valuable role in improving access to MOUD during the COVID\u201019 pandemic and beyond.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12570","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T14:17:11Z","timestamp":1615817831000},"page":"467-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["An examination of telehealth policy impacts on initial rural opioid use disorder treatment patterns during the COVID\u201019 pandemic"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-1677","authenticated-orcid":false,"given":"Phillip M.","family":"Hughes","sequence":"first","affiliation":[{"name":"Department of Research UNC Health Sciences at MAHEC  Asheville North Carolina USA"},{"name":"Division of Pharmaceutical Outcomes and Policy University of North Carolina (UNC) Eshelman School of Pharmacy  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve","family":"Verrastro","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Mountain Area Health Education Center (MAHEC)  Asheville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carriedelle Wilson","family":"Fusco","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Mountain Area Health Education Center (MAHEC)  Asheville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtenay Gilmore","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Research UNC Health Sciences at MAHEC  Asheville North Carolina USA"},{"name":"Department of Family Medicine Mountain Area Health Education Center (MAHEC)  Asheville North Carolina USA"},{"name":"Division of Practice Advancement and Clinical Education UNC Eshelman School of Pharmacy  Chapel Hill North Carolina USA"},{"name":"Charles George Veterans Affairs Medical Center  Asheville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2803-3747","authenticated-orcid":false,"given":"Bayla","family":"Ostrach","sequence":"additional","affiliation":[{"name":"Department of Research UNC Health Sciences at MAHEC  Asheville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1604339"},{"key":"e_1_2_6_3_1","volume-title":"Medications for Opioid Use Disorder Save Lives","author":"National Academies of Sciences, Engineering, and Medicine","year":"2019"},{"key":"e_1_2_6_4_1","unstructured":"CarrollJ GreenT NoonanR.Evidence\u2010Based Strategies for Preventing Opioid Overdose: What's Working in the United States 2018. Centers for Disease Control;2018. Accessed December 2 2019.https:\/\/www.cdc.gov\/drugoverdose\/pdf\/pubs\/2018\u2010evidence\u2010based\u2010strategies.pdf"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1212"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108176"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0898-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12499"},{"key":"e_1_2_6_9_1","unstructured":"National Harm Reduction Coalition.COVID\u201019 Guidance for People Who Use Drugs and Harm Reduction Programs.Harm Reduction Coalition Blog.2020. Accessed September 28 2020.https:\/\/harmreduction.org\/hrc2\/blog\/covid\u201019\u2010guidance\u2010for\u2010people\u2010who\u2010use\u2010drugs\u2010and\u2010harm\u2010reduction\u2010programs\/"},{"key":"e_1_2_6_10_1","unstructured":"U.S. Drug Enforcement Agency Diversion Control Division.COVID\u201019 Information Page. Accessed August 3 2020.https:\/\/www.deadiversion.usdoj.gov\/coronavirus.html"},{"key":"e_1_2_6_11_1","unstructured":"Assistant Secretary for Public Affairs.Telehealth: Delivering Care Safely During COVID\u201019.2020. 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