Breaking barriers: Assessing the feasibility and acceptability of telemedicine-assisted buprenorphine induction for opioid use disorder in India

Abstract

Background: Telemedicine-assisted buprenorphine (BNX) induction (TABI) has the potential to reduce the treatment gap for opioid use disorder.

Aim: This study investigated the acceptability and feasibility of TABI in India. This was a retrospective study from a specialized addiction treatment center in a teaching hospital.

Methods: TABI was introduced in November 2022; patients enrolled till May 2023 were included in the analysis. Feasibility was assessed by the proportion of patients who completed the TABI program, continued treatment for at least 3 months, and self-reported nonprescription opioid use during and after TABI. Acceptability was measured by patient satisfaction with TABI.

Results: Sixty patients were enrolled: Fifty-three patients (88.3%) were retained during the TABI program, and 50 patients (83.3%) remained in treatment at the 3-month follow-up. Thirty-five patients (58.3%) reported using nonprescription opioids during TABI, and 28 patients (46.7%) reported such use after completing the program. Thirty-five (58.3%) were satisfied with the program, and 15 (25%) said they would recommend it to others. Patients who missed scheduled in-person appointments (P < .001) at 1 week, did not return unused BNX-naloxone (P < .001), and were not satisfied (P = .004) were more likely to report nonprescription opioid use. Those who attended the in-person follow-up at 1 week (P = .004) and were satisfied (P = .01) and did not use nonprescription opioids either during (P = .003) or after (P < .001) TABI were more likely to be retained in treatment at 3 months.

Conclusion: The study shows TABI's acceptability and feasibility in a specialized addiction treatment setting; further research is needed for broader applicability.

Keywords: Buprenorphine; India; opioid use disorder; telemedicine.