Telehealth-Delivered Medication-Assisted Treatment for Opioid Use Disorder: A Systematic Review and Meta-Analysis of Efficacy and Outcomes
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Notice bibliographique
Résumé
Purpose and Background The opioid crisis continues to pose one of the most urgent public health challenges in North America and globally. While Medication-Assisted Treatment (MAT)—which combines FDA-approved medications such as buprenorphine, methadone, or naltrexone with counseling and behavioral therapies—has proven effective in reducing opioid use and overdose, barriers such as stigma, provider shortages, and limited access persist, particularly in rural and underserved areas. The COVID-19 pandemic accelerated the adoption of telehealth-delivered MAT, offering new possibilities for expanding equitable access to care. However, the evidence base remains fragmented. The purpose of this project is to synthesize existing research evaluating the efficacy, utilization, and patient outcomes of telehealth-delivered MAT compared with traditional in-person treatment for Opioid Use Disorder (OUD). This systematic review and meta-analysis aims to: Quantitatively assess treatment retention, overdose reduction, and other patient outcomes in telehealth-delivered MAT. Identify population and program factors influencing intervention effectiveness. Explore research and policy gaps, particularly those related to digital health equity, broadband access, and regulatory barriers to telehealth implementation. Methods Overview This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Databases searched: PubMed, Scopus, Web of Science, and Cochrane CENTRAL. Search timeframe: Inception to April 2024. Inclusion criteria: Studies reporting quantitative or mixed-methods data on telehealth-delivered MAT for OUD. Data management tools: EndNote (for deduplication) and Rayyan (for screening). Risk of bias tools: Newcastle-Ottawa Scale (NOS), AXIS, CASP, and TIDieR as appropriate. Meta-analysis model: Random-effects (DerSimonian–Laird) using log odds ratios and standardized mean differences. Registration: This protocol is preregistered on the Open Science Framework (OSF) to ensure transparency and reproducibility. Expected Outcomes The project is expected to: Provide pooled quantitative evidence on retention and overdose outcomes associated with telehealth MAT. Identify consistent patterns across populations, settings, and telehealth modalities. Offer clear policy recommendations supporting permanent telehealth prescribing flexibilities and integration into addiction care. Highlight key evidence gaps—such as lack of data from low- and middle-income countries, or inequities related to broadband access, digital literacy, and stigma. Impact and Knowledge Mobilization Findings will inform clinical practice, public health policy, and telehealth expansion strategies in addiction medicine. The results will be disseminated through peer-reviewed publications, conference presentations, and knowledge-mobilization partnerships with Canadian and U.S. healthcare institutions. In alignment with WHO and CDC telehealth frameworks, this project supports evidence-based digital health transformation to improve equitable access to OUD treatment.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,012 | 0,001 |
| Bibliométrie | 0,001 | 0,005 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle