Mobile low-threshold buprenorphine integrated with infectious disease services

Amanda Rosecrans, Robert Harris, Ronald E. Saxton, Margaret Cotterell, Meredith Zoltick, Catherine Willman, Ingrid Blackwell, Joy Bell, Darryl Hayes, Brian Weir, Susan Sherman, Gregory M. Lucas, Adena Greenbaum, Kathleen R. Page

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: In 2018, the Baltimore City Health Department launched a mobile clinic called Healthcare on The Spot, which offers low-threshold buprenorphine services integrated with health care services to meet the needs of people who use drugs. In addition to buprenorphine management, The Spot offers testing and treatment for hepatitis C, sexually transmitted infections, and HIV, as well as pre-exposure prophylaxis for HIV, wound care, vaccinations, naloxone distribution, and case management. Methods and materials: This cohort analysis includes clinical service data from the first 15 months of The Spot mobile clinic, from September 4, 2018, to November 23, 2019. The Spot co-located with the Baltimore syringe services program in five locations across the city. Descriptive data are provided for patient demographics and services provided, as well as percent of patients retained in buprenorphine treatment at one and three months. Logistic regression identified factors associated with retention at three months. Results: The Spot mobile clinic provided services to 569 individuals from September 4, 2018, to November 23, 2019, including prescribing buprenorphine to 73.8% and testing to more than 70% for at least one infectious disease. Patients receiving a prescription for buprenorphine were more likely to be tested for HIV, hepatitis C, and sexually transmitted infections, as well as receive treatment for hepatitis C and preventive services including vaccination and naloxone distribution. The Spot initiated HIV treatment for four patients and HIV pre-exposure prophylaxis for twelve patients. More than 32% of patients had hepatitis C; nineteen of these patients initiated treatment for hepatitis C with eight having a documented cure. Buprenorphine treatment retention was 56.0% at one month and 26.2% at three months. Patients who were Black or receiving treatment for hepatitis C were more likely to be retained in buprenorphine treatment at three months. Conclusions: Increasing access to integrated medical services and drug treatment through low-threshold, community-based models of care can be an effective tool for addressing the effects of drug use.

Original languageEnglish (US)
Article number108553
JournalJournal of Substance Abuse Treatment
DOIs
StateAccepted/In press - 2021

Keywords

  • Buprenorphine
  • Hepatitis C
  • Integrated care
  • Low-threshold
  • Mobile
  • Opioid use disorder

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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