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Table 1 Categorization and descriptions of evidence

From: The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review

Theme/Authors/Country

Study Design(s)

Data Source(s)

Key findings

Service delivery (n = 7, 47%)

 Prescriptions filled (n = 3)

  McIlveen et al. [17] (U.S./Oregon)

Retrospectiv

Electronic medical record of outpatient OUD treatment centers in Oregon

In-person medication dosing visits declined 33%, and take home medication increased 97% as intended.

  Jones et al. [18] (U.S./Nationwide)

Retrospective

IQVIA Total Patient Tracker

Database

Buprenorphine was dispensed at an expected rate, but intramuscular naloxone was not.

  Thornton et al. [19] (U.S./Texas)

Retrospective

Texas Prescription Monitoring Program dataset

Filling of daily buprenorphine prescriptions remained steady.

 EMSa and EDb utilization (n = 4)

  Glober et al. [20] (U.S./Indiana)

Retrospective

EMS and coroner’s office record in Marion County, Indiana

47% increase in calls for overdose.

  Holland et al. [21] (U.S./Nationwide)

Retrospective

Center for Disease Control and Prevention’s National Syndromic Surveillance Program

ED visits for reasons of opioid overdose were significantly higher during the pandemic compared to 2019 rates.

  Slavova et al. [22] (U.S./Kentucky)

Retrospective

Kentucky State Ambulance Reporting System

71% increase in refusal of transport to a hospital following an overdose call to EMS. 50% increase in overdose calls involving death at the scene.

  Weiner et al. [23] (U.S./Massachusetts)

Retrospective

Massachusetts Ambulance Trip Information System

After the stay-at-home order, most calls other than substance use dropped, but substance related EMS calls increased substantially.

Provider and patient experiences (n = 3, 20%)

 Provider experiences (n = 2)

  Caton et al. [24] (U.S./California)

Cross-sectional

338 clinicians from 57 primary care clinics in California

66% of clinics reported an easier time or an unchanged difference in retention and engagement of clients during the pandemic.

  Collins et al. [25] (U.S./Rhode Island)

Qualitative

14 Emergency room healthcare providers

Barriers persist in connecting patients to outpatient treatment, including capacity and infrastructure to use telehealth and, COVID-test requirements as a barrier to accessing treatment.

 Patient experiences (n = 1)

  Krawczyk et al. [26] (International)

Qualitative

300 posts of Reddit users related to COVID-19 and opioid used

Concerns over less in-person access to OUD treatment facilities, COVID-19 testing treatment requirements and exposure to COVID were reported as an influence on motivation to seek treatment.

Patient outcomes (n = 5, 33%)

 Overdose (n = 3)

  Khatri et al. [27] (U.S./Pennsylvania)

Retrospective

Philadelphia Dep Health Substance Use Dashboard and Medical Examiner’s Office Data

African Americans comprised 80% of overdose ED visits post-pandemic, compared to 63% pre-pandemic.

  Ochalek et al. [28] (U.S./Virginia)

Retrospective

Electronic medical record of Virginia Commonwealth University

During the pandemic, 2.5 patients were seen per day in the emergency department with opioid overdose, compared to 1.4 patients per day pre-pandemic.

  Rodda et al. [29] (U.S./California)

Retrospective

Electronic medical records and medical examiner records in San Francisco

Fatal overdoses significantly increased 60% in Non-Hispanic Black patients post-COVID restrictions, overdoses in Non-Hispanic White patients decreased.

 Retention in treatment (n = 1)

  Tofighi et al. [30] (U.S./New York)

Retrospective

Bellevue Hospital (NYC) electronic medical record

56tg6

  1. aEmergency Medical Services; bEmergency Department