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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