Pre-Paid Phone Distribution: A Tool for Improving Healthcare Engagement for People with Substance Use Disorder

Abstract

Background

The COVID-19 pandemic drove significant disruptions in access to substance use disorder (SUD) treatment and harm reduction services. Healthcare delivery via telemedicine has increasingly become the norm, rendering access to a phone essential for engagement in care.

Methods

Adult patients with SUD who lacked phones (n = 181) received a free, pre-paid phone during encounters with inpatient and outpatient SUD programs. We evaluated changes in healthcare engagement including completed in-person and telemedicine outpatient visits and telephone encounters 30 days before and after phone receipt. We used descriptive statistics, where appropriate, and paired t-tests to assess the change in healthcare engagement measures.

Results

Patients were predominantly male (64%) and white (62%) with high rates of homelessness (81%) and opioid use disorder (89%). When comparing 30 days before to 30 days after phone receipt, there was a significant increased change in number of telemedicine visits by 0.3 (95% CL [0.1,0.4], p < 0.001) and telephone encounters by 0.2 (95% CL [0.1,0.3], p = 0.004). There was no statistically significant change in in-person outpatient visits observed.

Conclusions

Pre-paid phone distribution to patients with SUD was associated with an increased healthcare engagement including telemedicine visits and encounters.

Keywords:

• COVID-19
• pre-paid phones
• substance use disorder
• health care engagement
• telemedicine
• homelessness

Acknowledgments

We thank Boston Medical Center’s Development Office, 2019–2020 and 2020–2021 Grayken Addiction Medicine Fellows, Addiction Consult service’s clinical social worker Emily Lapidus MSW, LICSW and wellness and recovery advocate, Theresa Rolley for their partnership in distributing pre-paid phones to patients.

Declaration of interest

GRM is partially funded by a Frontlines of Communities in the United States (FOCUS) grant from Gilead Sciences that supports HIV, hepatitis C virus, and hepatitis B virus screening and linkage to care. All other authors (AFP, RJ, KM, JY, HC, JK, TWP, JLT, ZWM) report no conflict of interest.

Additional information

Funding

Raagini Jawa was supported by the Research in Addiction Medicine Scholars (RAMS) Program, R25DA033211 and Boston University Clinical HIV/AIDS Research Training (BU-CHART) Program Funded by Grant # T32AI052074. Jessica L. Taylor is supported by a grant from the Massachusetts Department of Public Health Bureau of Substance Addiction Services [1NTF230M03163724179]. This work was also supported by the Clinical and Translational Science Institute at Boston University (Grant number: 1UL1-TR001430).