The following is a summary of the “Key implementation factors in telemedicine-delivered medications for opioid use disorder: a scoping review informed by normalisation process theory,” published in the January 2023 issue of Psychiatry by Teck, et al.
Telemedicine may improve access to opioid use disorder medications (MOUD). Telemedicine-delivered MOUD (TMOUD) has grown significantly due to the COVID-19 pandemic’s restrictions on in-person clinical contact. Still, this growth has yet to occur consistently across all health systems and countries. This Review aims to identify key factors in TMOUD implementation that may explain variations in uptake.
They scoped up articles reporting on the implementation of TMOUD services using three English language databases. As a result, 57 peer-reviewed articles were identified, open coding and thematic analysis were performed, and the results were interpreted using normalization process theory (NPT). NPT was originally used to evaluate telehealth innovations, but it has since been widely used to describe, assess, and develop the implementation potential of a wide range of complex healthcare interventions.
They aim to rationalize the current evidence base by categorizing our findings according to the four core NPT constructs of coherence, cognitive participation, collective action, and reflexive monitoring. They discover that variations in TMOUD models in practices are influenced by organizations’ risk attitudes, clinicians’ concerns about relinquishing control over standard practices, organizational-level support in overcoming operational and technological challenges, and evaluation methods that may overlook a potential widening of the digital divide.