Transition to telehealth visits at Kaiser Permanente Northern California may have encouraged some patients to seek care
Patients identified as having alcohol problems were more likely to initiate treatment during the COVID-19 pandemic and its shift to telehealth compared with the prior year, according to new research from Kaiser Permanente. The study authors said their findings suggest some patients may be more willing to seek help for their alcohol problem by phone or video.
“Our study contributes to understanding how the pandemic has impacted care for people with alcohol problems,” said lead author Vanessa Palzes, MPH, data consultant with the Kaiser Permanente Division of Research and its Center for Addiction and Mental Health Research. “Our findings suggest that virtual alcohol treatment could have some benefits for young adults and other people who have historically underused treatment.”
The study, published in Alcoholism Clinical & Experimental Research, tracked patients with a diagnosis for unhealthy alcohol use or alcohol use disorder. It compared those identified between March and December 2019 with those identified between March and December 2020.
The proportion of people who initiated treatment after being identified as having an alcohol problem increased from 24% before the pandemic to 32% after.
Patients were also more likely to stay in treatment in the pandemic year — 41% of patients engaged in 2 or more sessions after starting treatment, compared with 34% before the pandemic. There was also a small increase in the length of treatment retention, increasing by .7 days during 2020.
The increase in people seeking treatment could relate to greater alcohol use and mental health problems during the pandemic, the authors said. It’s also possible more people were willing to get care for an alcohol problem by telehealth, finding it less intimidating or stigmatizing than seeing a clinician in person.
“Getting people who are diagnosed into treatment, and having them stay, is always a big issue in this field,” said senior author Stacy Sterling, DrPH, MSW, an investigator with the Division of Research. “We wanted to learn how the pandemic and the shift to telehealth affected treatment initiation. And it seems access to virtual care may help make people initiate treatment, engage in treatment longer, and feel more comfortable.”
Before the pandemic, 5.9% of adults who initiated alcohol treatment used telehealth, which would involve phone or video visits. During 2020 that rose to 20.3%.
The study did not find indications that a “digital divide” — lack of access to the internet and virtual care by people in lower socioeconomic neighborhoods — was made worse for alcohol treatment during the pandemic. The analysis actually found some of the strongest telehealth use for alcohol treatment among people living in the highest economic deprivation areas.
All racial and ethnic groups studied had similar increases in use of alcohol treatment during the pandemic.
The demographics of people seeking help shifted during 2020, the study found — compared with 2019, more younger people aged 18 to 34 sought care. Younger adults are another group that has historically under-used treatment, so this finding was encouraging.
The study also found that people aged 35-49 who initiated treatment via telehealth stayed in treatment longer than any age group. “This may indicate that telehealth has helped make treatment more accessible and convenient to this group of adults who may have busy lives with young children and careers,” the authors wrote.
The study was funded by The National Institute on Alcohol Abuse and Alcoholism.
Additional co-authors were Felicia W. Chi, MPH, Verena Metz, PhD, and Cynthia Campbell, PhD, MPH, of the Division of Research, and Caroline Corriveau, MD, of The Permanente Medical Group.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow us @KPDOR.