Telehealth Prescriptions of Controlled Substances

SPECIFIC AIMS. We propose the following rapid evaluation/specific aims:

SA1.      To examine the perspectives of VHA prescribers on the quality of care and safety of CS prescribing, including opioids for pain and MOUD, currently and if changes are implemented to more easily allow cross-state and other policies related to prescribing of CS.

SA2.      To examine the perspectives of Veterans on the quality of care and safety of CS prescribing of opioids for pain and MOUD, currently and if changes are implemented to cross-state and other policies related to prescribing of CS.

SA3.      To conduct a narrative review examining the evidence-based practices and policy approaches to CS prescribing that maximize access to care and minimize risks. 

SA4.      To describe the total number and types of F2F, TH, and/or CC encounters involving CS prescriptions within VHA-paid care. We will examine variation by region (e.g., geographical region, VISN) to understand potential impacts if changes are implemented to cross-state and other policies related to prescribing of CS. In addition, through this SA we will establish a typology of CS (e.g., classes of CS) through which we can conduct further evaluations including SA5 which can establish different quality, safety, and outcomes based on different typologies of CS. 

SA5.      To begin an evaluation (e.g., database selection, variable operationalization, preliminary computations) to compare the quality, safety, and outcomes of CS through F2F, TH, and/or CC encounters, and identify fac-tors (e.g., patient characteristics, provider characteristics, use of risk mitigation strategies) associated with observed differences in quality, safety, and/or clinical outcomes associated with CS modalities. It is reason-able in FY2023 that outcomes (quality, safety, adverse events) will be established for each CS typology established in SA4. 

SA6.      To establish a rapid, expert evaluation team to track Veterans and process outcomes associated with future modifications of VA or federal policy.