Retention in Telehealth Treatment for Opioid Use Disorder Among Rural Populations: A Retrospective Cohort Study

Marlene C. Lira
Cynthia Jimes
M. Justin Coffey
Peer-Reviewed Article
December 2023
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A telehealth-delivered opioid use disorder (OUD) treatment program is associated with promising levels of care retention and medication adherence among rural populations.


OUD disproportionately impacts rural communities, a disparity driven in part by unequal access to health care services. Telehealth has emerged as a promising practice to improve access to care, particularly in rural communities. It has been shown to be an effective substitute for in-person treatment for substance use disorder, and in some cases, even leading to better patient outcomes than those who receive in-person treatment. This study assessed the retention in care and adherence to buprenorphine among adults in rural communities enrolled in Workit Health’s telehealth OUD treatment program.


At 1-, 3-, and 6-months post enrollment, rates of retention in care stood at 75%, 62%, and 52% respectively, while adherence to buprenorphine treatment was reported at 69%, 56%, and 49%. The study included over 1,800 adults residing in a U.S. Department of Agriculture designated rural zip code, with 67% enrolled in Medicaid.


This study demonstrates the feasibility and efficacy of telehealth-delivered OUD treatment in rural communities, with rates of care retention and medication adherence comparable to similarly designed studies evaluating in-person OUD treatment. Although Workit Health’s program makes technology support specialists available to patients, further efforts to facilitate access to technology that enables the use of telehealth services can increase the impact of programs like this, particularly given the “digital divide” often experienced in rural communities. For example, prior research has indicated that equipping patients with free video-enabled tablets leads to increases in use of both telehealth and in-person substance use disorder care.

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