"I want to stay here": Patient and staff perspectives on transitioning from a low-threshold buprenorphine program to clinic-based care
Martinez, Noelle G.; Truong, Ashley Q.; Nordeck, Courtney D.; Agus, Deborah; Genberg, Becky L.; Buresh, Megan E.
Why this matters
Low-threshold programs are usually designed to stabilize patients and move them on, and this study questions that design. Fewer than 10 percent of patients at a Baltimore van transitioned to clinic-based buprenorphine, and interviews with 20 patients and six staff found strong preferences for staying with the van.
Abstract
The Project Connections At Re-Entry (PCARE) Van is a low-threshold buprenorphine program operating outside the Baltimore City Detention Center. Like other low-threshold programs, PCARE seeks to engage a vulnerable population in care, stabilize patients, then transition patients to longer-term care; however, less than 10% of patients transition to clinic-based buprenorphine treatment. Our goal was to better understand these low transition rates and center patient perspectives in discussion of broader low-threshold program design. From December 2022 to June 2023, semi-structured interviews were conducted with 20 former and current PCARE patients and 6 staff members. We used deductive and inductive coding followed by thematic content analysis to identify themes around treatment experiences and care preferences. There were strong preferences among current and former patients for continuing buprenorphine treatment at the PCARE Van.