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The impact of COVID‐19 on trends in alcohol use disorder treatment in Veterans Health Administration.

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Title: The impact of COVID‐19 on trends in alcohol use disorder treatment in Veterans Health Administration.
Authors: Perumalswami, Ponni V., Kilpatrick, Sidonie, Frost, Madeline C., Adams, Megan A., Kim, Hyungjin Myra, Zhang, Lan, Lin, Lewei
Source: Addiction. Jun2023, Vol. 118 Issue 6, p1062-1071. 10p. 1 Chart, 4 Graphs.
Subjects: Alcoholism treatment, Medical care use, Psychotherapy, United States. Dept. of Veterans Affairs, Retrospective studies, Time series analysis, Descriptive statistics, Telepsychiatry, Longitudinal method, Veterans, COVID-19 pandemic
Geographic Terms: United States
Abstract: Background and Aims: The COVID‐19 pandemic disrupted health‐care provision in the United States and prompted increases in telehealth‐delivery of care. This study measured alcohol use disorder (AUD) treatment trends across visit modalities before and during COVID‐19. Design, Setting, Participants and Measurements: We conducted a national, retrospective cohort study with interrupted time‐series models to estimate the impact of COVID‐19 on AUD treatment in the Veterans Health Administration (VHA) in the United States during pre‐COVID‐19 (March 2019 to February 2020) and COVID‐19 (March 2020 to February 2021) periods. We analyzed monthly trends in telephone, video and in‐person visits for AUD treatment and compared patient and treatment characteristics of patients receiving AUD treatment between the pre‐COVID‐19 and COVID‐19 periods. AUD was defined using International Classification of Diseases, 10th revision (ICD‐10) codes for alcohol abuse (F10.1) and alcohol dependence (F10.2), which have previously been used to study AUD in VHA. Findings: The predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the beginning of the pre‐COVID period was 13.8% (n = 49 494). The predicted percentage decreased by 4.3% (P = 0.001) immediately at the start of the COVID‐19 period due to a decline in AUD psychotherapy. Despite an increase of 0.3% per month (P = 0.026) following the start of COVID‐19, the predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the end of the study period remained below the pre‐COVID‐19 period. In February 2021, AUD psychotherapy visits were primarily delivered by video (50%, 58 748), followed by in‐person (36.6%, 43 251) and telephone (13.8%, 16 299), while AUD pharmacotherapy visits were delivered by telephone (38.9%, 3623) followed by in‐person (34.3%, 3193) and video (26.8%, 2498) modalities. Characteristics of VHA patients receiving AUD treatment were largely similar between pre‐COVID‐19 and COVID‐19 periods. Conclusions: Despite increased telehealth use, the percentage of United States Veterans Health Administration patients with an alcohol use disorder (AUD) diagnosis receiving AUD treatment declined during COVID‐19 (March 2020 to February 2021) mainly due to a decrease in psychotherapy. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The impact of COVID‐19 on trends in alcohol use disorder treatment in Veterans Health Administration.
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Jun2023, Vol. 118 Issue 6, p1062-1071. 10p. 1 Chart, 4 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Alcoholism+treatment%22">Alcoholism treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+use%22">Medical care use</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotherapy%22">Psychotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22United+States%2E+Dept%2E+of+Veterans+Affairs%22">United States. Dept. of Veterans Affairs</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Time+series+analysis%22">Time series analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Telepsychiatry%22">Telepsychiatry</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Veterans%22">Veterans</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19+pandemic%22">COVID-19 pandemic</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
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  Data: Background and Aims: The COVID‐19 pandemic disrupted health‐care provision in the United States and prompted increases in telehealth‐delivery of care. This study measured alcohol use disorder (AUD) treatment trends across visit modalities before and during COVID‐19. Design, Setting, Participants and Measurements: We conducted a national, retrospective cohort study with interrupted time‐series models to estimate the impact of COVID‐19 on AUD treatment in the Veterans Health Administration (VHA) in the United States during pre‐COVID‐19 (March 2019 to February 2020) and COVID‐19 (March 2020 to February 2021) periods. We analyzed monthly trends in telephone, video and in‐person visits for AUD treatment and compared patient and treatment characteristics of patients receiving AUD treatment between the pre‐COVID‐19 and COVID‐19 periods. AUD was defined using International Classification of Diseases, 10th revision (ICD‐10) codes for alcohol abuse (F10.1) and alcohol dependence (F10.2), which have previously been used to study AUD in VHA. Findings: The predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the beginning of the pre‐COVID period was 13.8% (n = 49 494). The predicted percentage decreased by 4.3% (P = 0.001) immediately at the start of the COVID‐19 period due to a decline in AUD psychotherapy. Despite an increase of 0.3% per month (P = 0.026) following the start of COVID‐19, the predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the end of the study period remained below the pre‐COVID‐19 period. In February 2021, AUD psychotherapy visits were primarily delivered by video (50%, 58 748), followed by in‐person (36.6%, 43 251) and telephone (13.8%, 16 299), while AUD pharmacotherapy visits were delivered by telephone (38.9%, 3623) followed by in‐person (34.3%, 3193) and video (26.8%, 2498) modalities. Characteristics of VHA patients receiving AUD treatment were largely similar between pre‐COVID‐19 and COVID‐19 periods. Conclusions: Despite increased telehealth use, the percentage of United States Veterans Health Administration patients with an alcohol use disorder (AUD) diagnosis receiving AUD treatment declined during COVID‐19 (March 2020 to February 2021) mainly due to a decrease in psychotherapy. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/add.16156
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        Text: English
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      – SubjectFull: Alcoholism treatment
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