# Medication Assisted Therapies for Opioid Use Disorder among US Veterans: The Impact of Therapeutic History and Telehealth on Health Outcomes

> **NIH NIH R36** · UNIVERSITY OF IOWA · 2020 · $37,494

## Abstract

The long-term goal of this research proposal is to increase effective and successful strategies for management
of opioid use disorder (OUD) among US veterans. Compared to the general US population, veterans are at a
higher risk for substance dependence due to additional risk factors such as post-traumatic stress disorder,
chronic pain, sleep issues, and use of other substances such as alcohol or sedatives. Medication-assisted
therapies (MAT) serve as an effective treatment option for those with OUD and combines a pharmacological
treatment approach through opioid agonist treatment such as buprenorphine or buprenorphine/naloxone with
psychological therapies. Retention in MAT with buprenorphine has long-term benefits for veterans including
decreased mortality, illicit opiate use and criminal activity, and increased ability to obtain gainful employment.
The key challenge, however, is ensuring appropriate access to care and delivery of these approaches to US
veterans. Veterans more often live in rural areas where the burden of the opioid epidemic has significantly
escalated over the last 20 years. Additionally, access to treatment with MAT is a challenge in rural areas,
which suggests a significant proportion of veterans may not be receiving the care they need in a timely fashion.
For those who do receive MAT, long-term treatment retention is a marker of success; however, previous
studies have shown that only 35% of veterans with OUD receive medication-assisted therapies (MAT) and
nearly 40% discontinue MAT within the first year of treatment initiation.
In other chronic disease models, treatment retention and adherence improve when the patient and provider
have an existing therapeutic history. Additionally, telehealth services have expanded considerably in recent
years for mental health care, and has been recently been adopted for MAT and OUD management. The
objective is to identify the relationships between therapeutic relationships, telehealth, treatment retention, and
mortality. The central hypothesis is that existing therapeutic relationships and telehealth utilization to
overcome geographic disparities in buprenorphine access will improve treatment retention for OUD, which will
subsequently reduce suicide- and overdose-related deaths. This is a retrospective cohort study using
currently-available administrative data from the Veterans Health Administration (VHA) Corporate Data
Warehouse. The first aim of this study is to evaluate whether therapeutic history established between veterans
and their buprenorphine providers affect treatment retention. The second aim is to evaluate telehealth services
utilized during buprenorphine treatment within the VHA on treatment retention for patients. Finally, the third
aim is to evaluate whether treatment retention is associated with suicide and overdose mortality rates, which
will be obtained from the National Death Index. The objectives of this study are consistent with the priorities of
the National Institute...

## Key facts

- **NIH application ID:** 9956423
- **Project number:** 1R36DA050878-01
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Jayamalathi Priyanka Vakkalanka
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $37,494
- **Award type:** 1
- **Project period:** 2020-04-01 → 2021-05-16

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9956423

## Citation

> US National Institutes of Health, RePORTER application 9956423, Medication Assisted Therapies for Opioid Use Disorder among US Veterans: The Impact of Therapeutic History and Telehealth on Health Outcomes (1R36DA050878-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/9956423. Licensed CC0.

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