A Pilot Evaluation of a Telemedicine Pharmacist-Physician Management Model to Increase Access to Medication for Alcohol and Opioid Use Disorders for Rural Veterans.
Publication Title
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
Document Type
Article
Publication Date
3-1-2026
Keywords
washington; everett; diversity
Abstract
Background: Alcohol and opioid use disorders (AUD, OUD) cause significant morbidity and mortality among Veterans, yet only a minority receive evidence-based treatment.
Objective: Beginning in February 2022, we piloted a telemedicine pharmacist-physician management model (PPMM) in 6 Veterans Health Administration (VHA) primary care community-based outpatient clinics (CBOCs) across one VHA Health Care System to improve rural Veteran access to medications for opioid and alcohol use disorder (MOAD).
Methods: Veterans with AUD and/or OUD receiving primary care in participating CBOCs during the year following implementation were eligible for referral. Data obtained from study records and VHA electronic health records assessed patient sociodemographic and clinical characteristics and MOAD receipt among referred Veterans.
Results: There were 2274 Veterans diagnosed with AUD (n = 2062) and/or OUD (n = 307) receiving primary care from CBOCs during the study period. Of this population, 111 (4.9%) Veterans were referred and received PPMM services (AUD: n = 93; OUD: n = 9; AUD and OUD: n = 9), the mean age was 52 years, 92% were male, 68% White, and 39% lived in rural zip codes. Of the 102 Veterans referred to PPMM with AUD, 71% received medication. Of the 18 Veterans referred with OUD, 78% received medication. Most Veterans who were newly initiated on MOAD (N = 74) received medication within 72 h (N = 50, 68%).
Conclusions: In this pilot implementation of same-day telemedicine PPMM, high rates of MOAD receipt were seen among referred Veterans. However, most Veterans with AUD/OUD seen in participating clinics were not referred. Further evaluation of barriers and/or facilitators to referral are needed to increase program uptake.
Area of Special Interest
Mental Health
Specialty/Research Institute
Behavioral Health
Specialty/Research Institute
Population Health
Specialty/Research Institute
Health Information Technology
DOI
10.1111/jrh.70158
