Redefining low-threshold buprenorphine access in an integrated mobile clinic program: Factors associated with treatment retention
Harris, Robert; Stracker, Norberth; Rice, Molly; St Clair, Anne; Page, Kathleen; Rosecrans, Amanda
Abstract
The Spot mobile clinic provides low-threshold buprenorphine integrated with clinical and social services in Baltimore City, MD. The 2021 practice modifications included extended prescriptions, reduced toxicology testing frequency, extended stabilization timelines, higher maximum doses (up to 32 mg daily), and telemedicine access. The retrospective cohort study examined 341 patients from September 2021 through October 2023. Retention in care at 90 days was 60%. Patients prescribed 28-32 mg daily buprenorphine were 80% less likely to discontinue treatment compared to those receiving 16 mg or less. Engagement in wound care or hepatitis C treatment correlated with improved retention. Individuals experiencing homelessness remained engaged at rates comparable to stably housed patients.