Buprenorphine shared medical appointments for the treatment of opioid dependence in a homeless clinic

Subst Abus. 2017 Jan-Mar;38(1):26-30. doi: 10.1080/08897077.2016.1264535. Epub 2016 Nov 29.

Abstract

Background: Opioid misuse and dependence are prevalent and rising problems in the United States. Treatment with buprenorphine is a successful treatment option for individuals with opioid dependence. This study describes and preliminarily evaluates a unique delivery system that provides buprenorphine treatment via a shared medical appointment.

Methods: A retrospective medical record review on all 77 opioid-dependent patients referred for a buprenorphine shared medical appointment in a homeless clinic from 2010 to 2012.

Results: Most patients were currently homeless (61%), unemployed (92%), had an Axis I psychiatric diagnosis (81%), and had recent polysubstance use (53%). Of the 77 patients, 95% attended at least 1 shared medical appointment. Treatment retention at 12 and 24 weeks was 86% and 70%, respectively.

Conclusions: In a patient population with complex social and mental health histories, buprenorphine treatment via a shared medical appointment had high retention rates. Findings can help guide the development of unique delivery systems to serve real-world complex patients with opioid dependence.

Keywords: Buprenorphine; group visit; homeless; office-based treatment; shared medical appointment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ambulatory Care Facilities*
  • Appointments and Schedules*
  • Buprenorphine / therapeutic use*
  • Female
  • Humans
  • Ill-Housed Persons / psychology*
  • Male
  • Narcotic Antagonists / therapeutic use
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / drug therapy*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Program Evaluation
  • Retrospective Studies
  • Treatment Adherence and Compliance / statistics & numerical data
  • Young Adult

Substances

  • Narcotic Antagonists
  • Buprenorphine