Wednesday, November 17, 2021

Doctors worry that telehealth makes it more difficult for them to detect drug abuse by patients or the patients' risk for it

Telemedicine, or telehealth, has proven its value in the pandemic, but physicians are concerned that it leaves them less able to detect patients' misuse of drugs, a national poll of doctors found.

Quest Diagnostics found that two-thirds of physicians it surveyed "fear they missed signs of drug misuse during the pandemic, and, given how the global health crisis disrupted medical care, anticipate rising overdose deaths – especially those involving prescribed and non-prescribed (illicit) fentanyl – even as the pandemic subsides," the company said in a news release. For the full report, click here.

Quest noted an increase in drug-overdose deaths in the first year of the pandemic, and big increases in non-prescribed fentanyl and heroin among people whose test results it ran early in the pandemic. The poll found that 94% of primary-care doctors "reported seeing more patients experiencing stress, anxiety or other mental-health issues because of the pandemic and fear a correlation between rising mental health issues and prescription drug misuse."

Three-fourths of the 505 physicians surveyed said they believe telehealth limits their ability to determine if patients are misusing prescription drugs, or are at risk for it. The release said "91% of physicians feel confident they can recognize the signs of prescription drug misuse during in-office interactions with patients, but only 50% report the same confidence via telehealth visits."

Quest said nearly half of tested patients showed signs of drug misuse, and a fourth "engaged in drug combining, a particularly dangerous form of misuse," the release said. But about half of physicians "do not follow up with definitive tests when presumptive tests are positive."

The poll also found that only a third of physicians are "very confident" in their ability to properly prescribe naloxone, which blocks opioid overdose, to patients who may be at risk of overdose.

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