title: Buprenorphine shared medical appointments for the treatment of opioid dependence in a homeless clinic.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: a Santa Clara Valley Medical Center , San Jose , California , USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Doorley
authors.affiliation: a Santa Clara Valley Medical Center , San Jose , California , USA.
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Ho
authors.affiliation: a Santa Clara Valley Medical Center , San Jose , California , USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Echeverria
authors.affiliation: a Santa Clara Valley Medical Center , San Jose , California , USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Preston
authors.affiliation: a Santa Clara Valley Medical Center , San Jose , California , USA.
authors.forename: Huy
authors.initials: H
authors.lastname: Ngo
authors.affiliation: a Santa Clara Valley Medical Center , San Jose , California , USA.|b Stanford Medical Center , Stanford , California , USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kamal
authors.affiliation: c Albert Einstein College of Medicine and Montefiore Medical Center , Bronx , New York , USA.
authors.forename: Chinazo O
authors.initials: CO
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D001071:Appointments and Schedules; D002047:Buprenorphine / Q000627:therapeutic use*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D012189:Retrospective Studies; D000074822:Treatment Adherence and Compliance / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine
keywords: Buprenorphine; group visit; homeless; office-based treatment; shared medical appointment