Mobile, Community‐Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study
Background and Objectives Adults experiencing homelessness with opioid use disorder (OUD) utilize buprenorphine (BUP), a first‐line medication for OUD, at very low rates. Innovative and tailored approaches are needed to reduce barriers to treatment and increase utilization of BUP in this population....
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| Veröffentlicht in: | The American journal on addictions 2020-11, Vol.29 (6), p.485-491 |
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| container_title | The American journal on addictions |
| container_volume | 29 |
| creator | Iheanacho, Theddeus Payne, Kevin Tsai, Jack |
| description | Background and Objectives
Adults experiencing homelessness with opioid use disorder (OUD) utilize buprenorphine (BUP), a first‐line medication for OUD, at very low rates. Innovative and tailored approaches are needed to reduce barriers to treatment and increase utilization of BUP in this population. This study describes a pilot Mobile Community‐based Access Team (M‐CAT) that used mobile technology and FaceTime in addition to existing community‐based case management programs to provide BUP treatment for veterans with OUD experiencing homelessness who had difficulties engaging in the regular BUP clinic.
Methods
We conducted a retrospective chart review of veterans enrolled in M‐CAT or the usual BUP clinic between January 2015 and December 2017 (N = 36). We ed demographic, medical, substance use, prescription, health care utilization, and drug use data from medical records.
Results
Twelve veterans were enrolled in M‐CAT and 24 were enrolled in BUP clinic. Mean retention in treatment was 19.2 months (standard deviation [SD] = 10.2) in M‐CAT and 36 months (SD = 27.6) in BUP clinic. At the endpoint, 66.7% (n = 8) in M‐CAT and 100% (n = 24) in BUP clinic remained on BUP.
Discussion and Conclusion
M‐CAT is an innovative and tailored pilot project that successfully integrated specific OUD medication treatment into existing case management programs for veterans experiencing homelessness using mobile technology and Facetime. M‐CAT can potentially increase utilization of BUP for OUD among high‐risk population of veterans experiencing homelessness who are otherwise not engaged in treatment.
Scientific Significance
Integrating telemedicine, BUP treatment, and community‐based case management to treat OUD among veterans experiencing homelessness is feasible with high treatment retention. (Am J Addict 2020;29:485–491) |
| doi_str_mv | 10.1111/ajad.13055 |
| format | Article |
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Adults experiencing homelessness with opioid use disorder (OUD) utilize buprenorphine (BUP), a first‐line medication for OUD, at very low rates. Innovative and tailored approaches are needed to reduce barriers to treatment and increase utilization of BUP in this population. This study describes a pilot Mobile Community‐based Access Team (M‐CAT) that used mobile technology and FaceTime in addition to existing community‐based case management programs to provide BUP treatment for veterans with OUD experiencing homelessness who had difficulties engaging in the regular BUP clinic.
Methods
We conducted a retrospective chart review of veterans enrolled in M‐CAT or the usual BUP clinic between January 2015 and December 2017 (N = 36). We ed demographic, medical, substance use, prescription, health care utilization, and drug use data from medical records.
Results
Twelve veterans were enrolled in M‐CAT and 24 were enrolled in BUP clinic. Mean retention in treatment was 19.2 months (standard deviation [SD] = 10.2) in M‐CAT and 36 months (SD = 27.6) in BUP clinic. At the endpoint, 66.7% (n = 8) in M‐CAT and 100% (n = 24) in BUP clinic remained on BUP.
Discussion and Conclusion
M‐CAT is an innovative and tailored pilot project that successfully integrated specific OUD medication treatment into existing case management programs for veterans experiencing homelessness using mobile technology and Facetime. M‐CAT can potentially increase utilization of BUP for OUD among high‐risk population of veterans experiencing homelessness who are otherwise not engaged in treatment.
Scientific Significance
Integrating telemedicine, BUP treatment, and community‐based case management to treat OUD among veterans experiencing homelessness is feasible with high treatment retention. (Am J Addict 2020;29:485–491)</description><identifier>ISSN: 1055-0496</identifier><identifier>EISSN: 1521-0391</identifier><identifier>DOI: 10.1111/ajad.13055</identifier><identifier>PMID: 32367557</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject><![CDATA[Adult ; Aged ; Analgesics, Opioid - therapeutic use ; Buprenorphine - therapeutic use ; Case Management - organization & administration ; Community Health Services - methods ; Community Health Services - organization & administration ; Connecticut ; Feasibility Studies ; Female ; Follow-Up Studies ; Homeless Persons ; Humans ; Life Sciences & Biomedicine ; Male ; Middle Aged ; Mobile Applications ; Opiate Substitution Treatment - methods ; Opioid-Related Disorders - drug therapy ; Patient Compliance - statistics & numerical data ; Pilot Projects ; Retrospective Studies ; Science & Technology ; Substance Abuse ; Telemedicine - methods ; Telemedicine - organization & administration ; Treatment Outcome ; Veterans Health]]></subject><ispartof>The American journal on addictions, 2020-11, Vol.29 (6), p.485-491</ispartof><rights>2020 American Academy of Addiction Psychiatry</rights><rights>2020 American Academy of Addiction Psychiatry.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>24</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000530154800001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3295-29a4e6279ac4604fb0003e9aef84f0e82275d55b0a2ea861a84ad4de8a9974143</citedby><cites>FETCH-LOGICAL-c3295-29a4e6279ac4604fb0003e9aef84f0e82275d55b0a2ea861a84ad4de8a9974143</cites><orcidid>0000-0002-7538-3611 ; 0000-0002-0329-648X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajad.13055$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajad.13055$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27928,27929,45578,45579</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32367557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iheanacho, Theddeus</creatorcontrib><creatorcontrib>Payne, Kevin</creatorcontrib><creatorcontrib>Tsai, Jack</creatorcontrib><title>Mobile, Community‐Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study</title><title>The American journal on addictions</title><addtitle>AM J ADDICTION</addtitle><addtitle>Am J Addict</addtitle><description>Background and Objectives
Adults experiencing homelessness with opioid use disorder (OUD) utilize buprenorphine (BUP), a first‐line medication for OUD, at very low rates. Innovative and tailored approaches are needed to reduce barriers to treatment and increase utilization of BUP in this population. This study describes a pilot Mobile Community‐based Access Team (M‐CAT) that used mobile technology and FaceTime in addition to existing community‐based case management programs to provide BUP treatment for veterans with OUD experiencing homelessness who had difficulties engaging in the regular BUP clinic.
Methods
We conducted a retrospective chart review of veterans enrolled in M‐CAT or the usual BUP clinic between January 2015 and December 2017 (N = 36). We ed demographic, medical, substance use, prescription, health care utilization, and drug use data from medical records.
Results
Twelve veterans were enrolled in M‐CAT and 24 were enrolled in BUP clinic. Mean retention in treatment was 19.2 months (standard deviation [SD] = 10.2) in M‐CAT and 36 months (SD = 27.6) in BUP clinic. At the endpoint, 66.7% (n = 8) in M‐CAT and 100% (n = 24) in BUP clinic remained on BUP.
Discussion and Conclusion
M‐CAT is an innovative and tailored pilot project that successfully integrated specific OUD medication treatment into existing case management programs for veterans experiencing homelessness using mobile technology and Facetime. M‐CAT can potentially increase utilization of BUP for OUD among high‐risk population of veterans experiencing homelessness who are otherwise not engaged in treatment.
Scientific Significance
Integrating telemedicine, BUP treatment, and community‐based case management to treat OUD among veterans experiencing homelessness is feasible with high treatment retention. (Am J Addict 2020;29:485–491)</description><subject>Adult</subject><subject>Aged</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Buprenorphine - therapeutic use</subject><subject>Case Management - organization & administration</subject><subject>Community Health Services - methods</subject><subject>Community Health Services - organization & administration</subject><subject>Connecticut</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Homeless Persons</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mobile Applications</subject><subject>Opiate Substitution Treatment - methods</subject><subject>Opioid-Related Disorders - drug therapy</subject><subject>Patient Compliance - statistics & numerical data</subject><subject>Pilot Projects</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Substance Abuse</subject><subject>Telemedicine - methods</subject><subject>Telemedicine - organization & administration</subject><subject>Treatment Outcome</subject><subject>Veterans Health</subject><issn>1055-0496</issn><issn>1521-0391</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ARHDP</sourceid><sourceid>EIF</sourceid><recordid>eNqNkd9O1TAYwBsjEQRvfADTa2HYbu22encYIBoMJIJeLt_Wb1Jy1i5tFzl3vICJz-iT0ONBLo1f0rRpft-f_krIa84OeYp3cAv6kBdMymdkh8ucZ6xQ_Hk6p6uMCVVuk5ch3LIUtSpfkO0iL8pKymqH_PzsOrPEA9q4cZytiavf97-OIKCmR_Pk0To_3RiL9MojxBFtpIPz9CtG9GADPbmb0Bu0vbHf6ZkbcYkh2LToNxNv6MVknNH0OiA9NsF5jf49XdBLs3TxgJ4iBJPap670S5z1ao9sDbAM-Opx3yXXpydXzVl2fvHhY7M4z_oiVzLLFQgs80pBL0omhi49rEAFONRiYFjneSW1lB2DHKEuOdQCtNBYg1KV4KLYJW83dXvvQvA4tJM3I_hVy1m7dtqunbZ_nCb4zQae5m5E_YT-lZiA_Q3wAzs3hH6tA5-wNJssGJeiXvvnia7_n25MhGicbdxsY0rlj6npy1b_mLldfFocb6Z_AF3gpPA</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Iheanacho, Theddeus</creator><creator>Payne, Kevin</creator><creator>Tsai, Jack</creator><general>Wiley</general><scope>17B</scope><scope>ARHDP</scope><scope>BLEPL</scope><scope>DVR</scope><scope>EGQ</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-7538-3611</orcidid><orcidid>https://orcid.org/0000-0002-0329-648X</orcidid></search><sort><creationdate>202011</creationdate><title>Mobile, Community‐Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study</title><author>Iheanacho, Theddeus ; Payne, Kevin ; Tsai, Jack</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3295-29a4e6279ac4604fb0003e9aef84f0e82275d55b0a2ea861a84ad4de8a9974143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Buprenorphine - therapeutic use</topic><topic>Case Management - organization & administration</topic><topic>Community Health Services - methods</topic><topic>Community Health Services - organization & administration</topic><topic>Connecticut</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Homeless Persons</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mobile Applications</topic><topic>Opiate Substitution Treatment - methods</topic><topic>Opioid-Related Disorders - drug therapy</topic><topic>Patient Compliance - statistics & numerical data</topic><topic>Pilot Projects</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Substance Abuse</topic><topic>Telemedicine - methods</topic><topic>Telemedicine - organization & administration</topic><topic>Treatment Outcome</topic><topic>Veterans Health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iheanacho, Theddeus</creatorcontrib><creatorcontrib>Payne, Kevin</creatorcontrib><creatorcontrib>Tsai, Jack</creatorcontrib><collection>Web of Knowledge</collection><collection>Web of Science - Social Sciences Citation Index – 2020</collection><collection>Web of Science Core Collection</collection><collection>Social Sciences Citation Index</collection><collection>Web of Science Primary (SCIE, SSCI & AHCI)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>The American journal on addictions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iheanacho, Theddeus</au><au>Payne, Kevin</au><au>Tsai, Jack</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mobile, Community‐Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study</atitle><jtitle>The American journal on addictions</jtitle><stitle>AM J ADDICTION</stitle><addtitle>Am J Addict</addtitle><date>2020-11</date><risdate>2020</risdate><volume>29</volume><issue>6</issue><spage>485</spage><epage>491</epage><pages>485-491</pages><issn>1055-0496</issn><eissn>1521-0391</eissn><abstract>Background and Objectives
Adults experiencing homelessness with opioid use disorder (OUD) utilize buprenorphine (BUP), a first‐line medication for OUD, at very low rates. Innovative and tailored approaches are needed to reduce barriers to treatment and increase utilization of BUP in this population. This study describes a pilot Mobile Community‐based Access Team (M‐CAT) that used mobile technology and FaceTime in addition to existing community‐based case management programs to provide BUP treatment for veterans with OUD experiencing homelessness who had difficulties engaging in the regular BUP clinic.
Methods
We conducted a retrospective chart review of veterans enrolled in M‐CAT or the usual BUP clinic between January 2015 and December 2017 (N = 36). We ed demographic, medical, substance use, prescription, health care utilization, and drug use data from medical records.
Results
Twelve veterans were enrolled in M‐CAT and 24 were enrolled in BUP clinic. Mean retention in treatment was 19.2 months (standard deviation [SD] = 10.2) in M‐CAT and 36 months (SD = 27.6) in BUP clinic. At the endpoint, 66.7% (n = 8) in M‐CAT and 100% (n = 24) in BUP clinic remained on BUP.
Discussion and Conclusion
M‐CAT is an innovative and tailored pilot project that successfully integrated specific OUD medication treatment into existing case management programs for veterans experiencing homelessness using mobile technology and Facetime. M‐CAT can potentially increase utilization of BUP for OUD among high‐risk population of veterans experiencing homelessness who are otherwise not engaged in treatment.
Scientific Significance
Integrating telemedicine, BUP treatment, and community‐based case management to treat OUD among veterans experiencing homelessness is feasible with high treatment retention. (Am J Addict 2020;29:485–491)</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>32367557</pmid><doi>10.1111/ajad.13055</doi><orcidid>https://orcid.org/0000-0002-7538-3611</orcidid><orcidid>https://orcid.org/0000-0002-0329-648X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1055-0496 |
| ispartof | The American journal on addictions, 2020-11, Vol.29 (6), p.485-491 |
| issn | 1055-0496 1521-0391 |
| language | eng |
| recordid | cdi_pubmed_primary_32367557 |
| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adult Aged Analgesics, Opioid - therapeutic use Buprenorphine - therapeutic use Case Management - organization & administration Community Health Services - methods Community Health Services - organization & administration Connecticut Feasibility Studies Female Follow-Up Studies Homeless Persons Humans Life Sciences & Biomedicine Male Middle Aged Mobile Applications Opiate Substitution Treatment - methods Opioid-Related Disorders - drug therapy Patient Compliance - statistics & numerical data Pilot Projects Retrospective Studies Science & Technology Substance Abuse Telemedicine - methods Telemedicine - organization & administration Treatment Outcome Veterans Health |
| title | Mobile, Community‐Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study |
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