. 2025 May;71(5):e82-e89.

doi: 10.46747/cfp.7105e82.

Electronic consultation questions asked to addiction medicine specialists by primary care providers: Retrospective content analysis

Cynthia Chan¹, Grace Zhu², Clare Liddy³, Daniel T Myran⁴, Erin Keely⁵, Arun Radhakrishnan⁶

Affiliations

¹ Family physician practising in Ontario.
² Family physician practising in British Columbia.
³ Chair and Professor in the Department of Family Medicine at the University of Ottawa in Ontario, Clinician Investigator in the CT Lamont Primary Health Care Research Centre at the Bruyère Health Research Institute, and Co-Executive Director of the Ontario eConsult Centre of Excellence.
⁴ Public health and preventative medicine physician at the Ottawa Hospital, and Research Chair and Assistant Professor in Social Accountability in the Department of Family Medicine at the University of Ottawa.
⁵ Endocrinologist at the Ottawa Hospital, Professor in the Department of Medicine at the University of Ottawa, and Co-Executive Director of the Ontario eConsult Centre of Excellence.
⁶ Family physician and Assistant Professor in the Department of Family Medicine at the University of Ottawa, Investigator at the Bruyère Health Research Institute, and Lead for Clinical Research in the Department of Family Practice at the Ottawa Hospital.

PMID: 40368624
PMCID: PMC12087554
DOI: 10.46747/cfp.7105e82

Electronic consultation questions asked to addiction medicine specialists by primary care providers: Retrospective content analysis

Cynthia Chan et al. Can Fam Physician. 2025 May.

. 2025 May;71(5):e82-e89.

doi: 10.46747/cfp.7105e82.

Authors

Cynthia Chan¹, Grace Zhu², Clare Liddy³, Daniel T Myran⁴, Erin Keely⁵, Arun Radhakrishnan⁶

Affiliations

¹ Family physician practising in Ontario.
² Family physician practising in British Columbia.
³ Chair and Professor in the Department of Family Medicine at the University of Ottawa in Ontario, Clinician Investigator in the CT Lamont Primary Health Care Research Centre at the Bruyère Health Research Institute, and Co-Executive Director of the Ontario eConsult Centre of Excellence.
⁴ Public health and preventative medicine physician at the Ottawa Hospital, and Research Chair and Assistant Professor in Social Accountability in the Department of Family Medicine at the University of Ottawa.
⁵ Endocrinologist at the Ottawa Hospital, Professor in the Department of Medicine at the University of Ottawa, and Co-Executive Director of the Ontario eConsult Centre of Excellence.
⁶ Family physician and Assistant Professor in the Department of Family Medicine at the University of Ottawa, Investigator at the Bruyère Health Research Institute, and Lead for Clinical Research in the Department of Family Practice at the Ottawa Hospital.

PMID: 40368624
PMCID: PMC12087554
DOI: 10.46747/cfp.7105e82

Abstract
in English, French

Objective: To determine the major themes among clinical questions asked to addiction medicine specialists sent by primary care providers (PCPs) via the Champlain Building Access to Specialists through the eConsultation (BASE™) electronic consultation (eConsult) service and the PCP-perceived benefits of this service.

Design: A descriptive, retrospective study of the eConsult cases submitted to addiction medicine specialists between January 1, 2020, and December 31, 2021.

Setting: Champlain region of eastern Ontario.

Participants: Primary care providers who sent an eConsult to addiction medicine.

Interventions: The BASE™ eConsult service was used to facilitate communication between PCPs and addiction medicine specialists.

Main outcome measures: The classification of question types and clinical topics asked in eConsult cases sent to addiction medicine specialists by PCPs, and the answers in the close-out surveys completed by PCPs after eConsult was completed.

Results: Primary care providers sought advice regarding opioids (38.0%) and alcohol (34.9%). The most common question types involved pharmacologic (77.5%) and nonpharmacologic (65.1%) management of patients with substance use. Electronic consultations were most frequently related to the clinical topic of chronic pain (28.7%). Over 95% of eConsults were answered by a specialist within 7 calendar days. Providers reported finding the eConsult responses helpful, with nearly one-third of PCPs reporting a potential referral was avoided following an eConsult from specialists.

Conclusion: This study demonstrates that PCPs sought advice on management regarding opioids and alcohol, reflecting the challenges in controlled substance prescribing during an opioid crisis, with alcohol use disorder being the most prevalent substance use disorder in Canada. The eConsult service provided an accessible, timely, and beneficial process for PCPs to obtain addiction medicine specialist advice. Given the overlap with the COVID-19 pandemic and the study timeframe, further studies to examine postpandemic eConsults will allow for better generalizability of the findings.

Objectif: Déterminer les principaux thèmes qui se dégagent des questions cliniques posées à des spécialistes en médecine des dépendances par des professionnels des soins primaires (PSP) dans le cadre du programme d’amélioration de l’accès à des spécialistes de la région de Champlain et de son service de consultation électronique eConsultation (BASE™) (eConsult), de même que les avantages de ce service tels que perçus par les PSP.

Type d’étude: Une étude descriptive rétrospective sur les cas d’eConsult soumis à des spécialistes en médecine des dépendances entre le 1^er janvier 2020 et le 31 décembre 2021.

Contexte: La région de Champlain de l’Est ontarien.

Participants: Les professionnels des soins primaires qui ont demandé une eConsult en médecine des dépendances.

Interventions: Le service eConsult BASE™ a été utilisé pour faciliter la communication entre les PSP et les spécialistes de la médecine des dépendances.

Principaux paramètres à l’étude: La classification des types de questions et des sujets cliniques en cause dans les cas d’eConsult envoyés par des PSP à des spécialistes de la médecine des dépendances et les réponses données par les PSP dans les sondages de clôture une fois le service eConsult rendu.

Résultats: Les professionnels des soins primaires ont demandé des conseils concernant les opioïdes (38,0 %) et l’alcool (34,9 %). Les types de questions les plus fréquents portaient sur la prise en charge pharmacologique (77,5 %) et non pharmacologique (65,1 %) des patients ayant un trouble de consommation de substances. Les consultations électroniques avaient le plus souvent trait au sujet clinique de la douleur chronique (28,7 %). Plus de 95 % des eConsult ont reçu la réponse d’un spécialiste dans les 7 jours de calendrier suivant la demande. Les cliniciens ont signalé avoir trouvé utiles les réponses d’eConsult et près du tiers des PSP ont indiqué qu’une demande de consultation avait été potentiellement évitée grâce à l’eConsult avec des spécialistes.

Conclusion: Cette étude démontre que les PSP ont sollicité des conseils sur la prise en charge en ce qui avait trait aux opioïdes et à l’alcool, ce qui reflète les défis entourant la prescription de substances contrôlées durant une crise des opioïdes et alors que le trouble de consommation d’alcool est le problème d’abus de substances le plus prévalent au Canada. Le service eConsult a offert aux PSP un processus accessible, en temps opportun et bénéfique pour obtenir des conseils de spécialistes en médecine des dépendances. Étant donné le chevauchement de la pandémie de la COVID-19 et de la période visée par l’étude, d’autres études pour examiner les eConsult ultérieurs à la pandémie permettront de mieux déterminer si les constatations sont généralisables.

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Figures

**Figure 1.**
Classification of addiction medicine electronic consultation cases by question type (diagnosis, drug treatment, and management)

See this image and copyright information in PMC

References

1. Substance use and addiction. Toronto, ON: Canadian Mental Health Association; 2025. Available from: https://ontario.cmha.ca/addiction-and-substance-use-and-addiction. Accessed 2025 Mar 24.
1. Pearson C, Janz T, Ali J.. Mental and substance use disorders in Canada. Ottawa, ON: Statistics Canada; 2015. Available from: https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11855-eng.htm. Accessed 2025 Mar 24.
1. Canadian substance use costs and harms. Data visualization tool. Victoria, BC: Canadian Centre on Substance Use and Addiction, Canadian Institute for Substance Use Research; 2025. Available from: https://csuch.ca/explore-the-data. Accessed 2025 Mar 24.
1. Health behaviours and substance use. Ottawa, ON: Statistics Canada; 2024. Available from: https://www150.statcan.gc.ca/n1/pub/82-570-x/2023001/section2-eng.htm. Accessed 2025 Mar 24.
1. Myran DT, Hsu AT, Smith G, Tanuseputro P.. Rates of emergency department visits attributable to alcohol use in Ontario from 2003 to 2016: a retrospective population-level study. CMAJ 2019;191(29):E804-10. - PMC - PubMed

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Electronic consultation questions asked to addiction medicine specialists by primary care providers: Retrospective content analysis

Affiliations

Electronic consultation questions asked to addiction medicine specialists by primary care providers: Retrospective content analysis

Authors

Affiliations

Abstract
in English, French

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Abstract in English, French

Figures

References

Publication types

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LinkOut - more resources

Full Text Sources

Abstract
in English, French