Feasibility of Implementing Shared Medical Appointments (SMAs) for Office-Based Opioid Treatment With Buprenorphine: A Pilot Study.
BACKGROUND
Shared medical appointments (SMAs) are designed to improve patient satisfaction and increase access to treatment. In a typical SMA, 6-12 patients with similar diagnoses attend a group appointment with their health care providers, often lasting 60-120 minutes. All components of an individual visit are completed, and additional time is spent providing education and facilitating peer support. The aim of this study was to report on patient and program outcomes after implementation of SMA-based office-based opioid treatment with buprenorphine.


METHODS
The study was conducted at a hospital-based outpatient psychiatric clinic that previously did not offer any office-based opioid treatment with buprenorphine. Demographic and clinical data (treatment retention, depression, anxiety, craving scores, and urine toxicology results) were extracted from the medical records. Patients were recruited to complete a survey assessing their experience.


RESULTS
Ninety-three patients enrolled in the program, and 52.7% remained in treatment at 6 months. The proportion of aberrant opioid urine results, depression, anxiety, and craving decreased significantly from baseline to 6 months. Twenty-two patients completed the survey, who generally agreed that the SMA format allowed for more time with physicians, more support from peers, better coordination of care, and more predictable times for visits.


CONCLUSIONS
Implementation of an SMA-based buprenorphine program was feasible, with treatment outcomes comparable to traditional models of care. More research is needed to explore the impact of SMA on buprenorphine treatment.
a Department of Psychiatry , Brigham and Women's Hospital , Boston , Massachusetts , USA.
Joji
J
Suzuki
Jennifer
J
Zinser
Brenda
B
Klaiber
Melanie
M
Hannon
Hope
H
Grassi
Madeline
M
Spinosa
Altagracia
A
Ramirez
Mohammed
M
Issa
Siu Ping
SP
Chin Feman
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001071:Appointments and Schedules; D002047:Buprenorphine / Q000627:therapeutic use*; D003299:Cooperative Behavior; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D017060:Patient Satisfaction; D010865:Pilot Projects; D055815:Young Adult
D000701:Analgesics, Opioid; D002047:Buprenorphine
Office-based opioid treatment; buprenorphine; shared medical appointments