Margot Trotter Davis , Cynthia Tschampl , Dominic Hodgkin , Craig Regis , Elsie Taveras , Ben Plant , Brittni Reilly , Constance Horgan
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In the current evaluation we conducted site visits to the four new mobile clinics and conducted one individual semi-structured provider interview at each of the four clinics. In addition, we supported a monthly learning collaborative of staff in four agencies involved with this initiative. The current evaluation used the RE-AIM framework to analyze the implementation of the mobile clinics.</p></div><div><h3>Results</h3><p>Clinicians described many challenges and opportunities. The typical patient is unhoused, having a substance use disorder, and disconnected from traditional pathways to care. Clinicians are able to initiate people on buprenorphine largely due to the trust they establish with patients. Referral networks are facilitated by established community linkages. The philosophy of care is patient-centered. Mobile clinics provide a wide range of healthcare services including harm reduction, although finding a location to park and relations with police can be challenging. The workflow is uneven due to the model that is built on unscheduled visits.</p></div><div><h3>Conclusion</h3><p>This study provides insight into how mobile clinics address the gaps in care for persons with OUD and fatal opioid overdoses. Harm reduction services are a critical intervention and financial sustainability of mobile clinics has to be tested.</p></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mobile clinics for opioid use disorders: What they do and how they do it. 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In the current evaluation we conducted site visits to the four new mobile clinics and conducted one individual semi-structured provider interview at each of the four clinics. In addition, we supported a monthly learning collaborative of staff in four agencies involved with this initiative. The current evaluation used the RE-AIM framework to analyze the implementation of the mobile clinics.</p></div><div><h3>Results</h3><p>Clinicians described many challenges and opportunities. The typical patient is unhoused, having a substance use disorder, and disconnected from traditional pathways to care. Clinicians are able to initiate people on buprenorphine largely due to the trust they establish with patients. Referral networks are facilitated by established community linkages. The philosophy of care is patient-centered. Mobile clinics provide a wide range of healthcare services including harm reduction, although finding a location to park and relations with police can be challenging. The workflow is uneven due to the model that is built on unscheduled visits.</p></div><div><h3>Conclusion</h3><p>This study provides insight into how mobile clinics address the gaps in care for persons with OUD and fatal opioid overdoses. 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引用次数: 0
摘要
导言药物使用失调症(SUD)患者在接受循证治疗时面临许多障碍,包括治疗途径和治疗费用。吸毒者面临的耻辱感限制了他们去传统的诊所就诊。2020 年,马萨诸塞州公共卫生部(DPH)的 "流动戒毒服务计划"(Mobile Addiction Services Program)扩大了一项名为 "社区关怀"(Community Care in Reach)的计划,该计划在减少医疗障碍和增加患者就诊次数方面取得了成功。在本次评估中,我们对四家新的流动诊所进行了实地考察,并在四家诊所中的每一家进行了一次单独的半结构化医疗服务提供者访谈。此外,我们还支持参与该计划的四家机构的员工每月开展一次学习合作。本次评估使用 RE-AIM 框架来分析流动诊所的实施情况。典型的病人没有住房,有药物使用障碍,与传统的治疗途径脱节。临床医生之所以能够让患者开始服用丁丙诺啡,主要是因为他们与患者建立了信任。已建立的社区联系为转介网络提供了便利。护理理念是以病人为中心。流动诊所提供广泛的医疗保健服务,包括减低伤害服务,但寻找停车地点以及与警方的关系可能具有挑战性。这项研究深入探讨了流动诊所如何解决对 OUD 和致命阿片类药物过量患者的护理缺口。减低伤害服务是一项重要的干预措施,流动诊所的财务可持续性还有待检验。
Mobile clinics for opioid use disorders: What they do and how they do it. A qualitative analysis
Introduction
People with substance use disorders (SUD) face many barriers to receiving evidence-based treatments including access to and cost of treatment. People who use drugs face stigma that limits access to traditional office-based clinics. With the goal of reducing morbidity and mortality, mobile clinics reduce many of these barriers by providing harm reduction and on-demand low-threshold medical care.
Methods
In 2020 Massachusetts Department of Public Health (DPH) Mobile Addiction Services Program expanded a program called Community Care in Reach building on its success in reducing barriers to care and increasing patient encounters. In the current evaluation we conducted site visits to the four new mobile clinics and conducted one individual semi-structured provider interview at each of the four clinics. In addition, we supported a monthly learning collaborative of staff in four agencies involved with this initiative. The current evaluation used the RE-AIM framework to analyze the implementation of the mobile clinics.
Results
Clinicians described many challenges and opportunities. The typical patient is unhoused, having a substance use disorder, and disconnected from traditional pathways to care. Clinicians are able to initiate people on buprenorphine largely due to the trust they establish with patients. Referral networks are facilitated by established community linkages. The philosophy of care is patient-centered. Mobile clinics provide a wide range of healthcare services including harm reduction, although finding a location to park and relations with police can be challenging. The workflow is uneven due to the model that is built on unscheduled visits.
Conclusion
This study provides insight into how mobile clinics address the gaps in care for persons with OUD and fatal opioid overdoses. Harm reduction services are a critical intervention and financial sustainability of mobile clinics has to be tested.