Can nurse practitioners deliver effective and efficient telemedicine-based care for pregnant women with opioid use disorder living in Northern BC?

Opioid use disorder in pregnancy has escalated perilously in BC in recent years, corresponding to the epidemic observed in the general population. Although evidence-informed treatments exist, many pregnant women are unable to access life-saving treatment due in part to their rural or remote location. Advances in telemedicine (TM), in particular videoconferencing-based technology innovations, are postulated as one way to improve rural residents’ access to primary care services. Presently, little is known about the effectiveness and efficiency of providing opioid agonist treatment via distal technologies for pregnant women living in northern BC. Therefore, an integrative literature review has been conducted to answer the following research question: Can nurse practitioners deliver effective and efficient TM-based care for pregnant women with opioid use disorder living in northern BC? Findings of this review suggest there is currently not enough quality evidence to determine whether TM can meet the needs of rural pregnant women in BC with opioid use disorder and to what extent TM could provide effective and efficient care in a rural context. In fact, evidence suggests that health care providers and researchers need to step back from current TM approaches and return to the developmental phase of designing, implementing, and evaluating health care service delivery via TM. Recommendations and strategies for TM implementation at the policy, organizational, and patient levels for primary care providers are discussed.