Advancing virtual primary care for people with opioid use disorder
British Columbia continues to grapple with dual public health emergencies: the COVID‑19 pandemic and the opioid-related overdose crisis. Pandemic-related public health guidelines have rarely recognised the need to modify approaches to support communities that experience marginalisation, including individuals with opioid use disorder (OUD). One example is the broad move to virtual forms of primary care, which may compromise healthcare access for people with OUD, who frequently face concurrent challenges of poverty and insecure housing or homelessness, making make accessing a virtual visit difficult. Compromised access to primary care may interrupt OUD treatments and may worsen co-occurring health problems such as HIV, Hepatitis C and mental health issues, ultimately leading to increased morbidity and mortality. We propose a two-year study to characterize changes to primary care access and to assess patient outcomes following the rapid introduction of virtual care for people with OUD. We have three research objectives: 1) To document the experiences and perspectives of a) people with OUD navigating access to virtual visits, and b) clinicians providing virtual visits during the pandemic; 2) To describe the uptake of virtual care, its impact on access and downstream health outcomes for people with OUD; and 3) to co-create a suite of educational resources for clinicians and people with OUD that support equitable access to virtual primary care. The project will include analyses of administrative health data, interviews with people with lived/living experience of OUD and their clinicians, and facilitated group dialogues. This work will enhance understanding about the impact of virtual models of care on people with OUD. Findings will be used to shape best practices for implementing virtual care amongst communities that experience marginalisation, both in future public health emergencies and as part of regular primary care.