Evidence map›Paper›PMID 38987479›Full record

ArticleJournal of general internal medicine2024

Outpatient-Based Opioid Treatment Engagement and Attendance: A Prospective Cohort Study of Homeless-Experienced Adults.

Danielle R Fine, Katherine Hart, Natalia Critchley, Yuchiao Chang, Susan Regan, Andrea Joyce, Emily Tixier, Nora Sporn, Jessie Gaeta, Joe Wright and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Danielle R FineDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA. drfine@mgh.harvard.edu.ORCID 0000-0002-1970-3342
Katherine HartDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Natalia CritchleyDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Yuchiao ChangDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Susan ReganDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Andrea JoyceDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Emily TixierDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Nora SpornDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Jessie GaetaBoston Health Care for the Homeless Program, 780 Albany Street, Boston, MA, 02118, USA.
Joe WrightBoston Health Care for the Homeless Program, 780 Albany Street, Boston, MA, 02118, USA.
Gina KruseDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
Travis P BaggettDivision of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.

Funding

Career Development Program in Substance Use and Addiction MedicineK12DA043490 · NIDA · MASSACHUSETTS GENERAL HOSPITAL · PI A EDEN EVINS, NANCY A RIGOTTI · 2017 to 2026
$4.7M
Peer recovery support for people experiencing homelessness with opioid use disorderK23DA058200 · NIDA · MASSACHUSETTS GENERAL HOSPITAL · PI Danielle Rebecca Fine · 2024 to 2026
$668k
NIDA NIH HHS K12 DA043490NIDA NIH HHS K12DA043490NIDA NIH HHS K23 DA058200
6 · The paper itself

Abstract

backgroundThe opioid overdose epidemic disproportionately impacts people experiencing homelessness. Outpatient-based opioid treatment (OBOT) programs have been established in homeless health care settings across the USA, but little is known about the success of these programs in engaging and retaining this highly marginalized patient population in addiction care.

objectiveTo evaluate predictors of initial engagement and subsequent attendance in a homeless-tailored OBOT program.

designProspective cohort study with 4 months of follow-up.

participantsA total of 148 homeless-experienced adults (≥18 years) who newly enrolled in the Boston Healthcare for the Homeless Program (BHCHP) OBOT program over a 1-year period (1/6/2022-1/5/2023). MAIN MEASURES: The primary outcomes were (1) initial OBOT program engagement, defined as having ≥2 additional OBOT visits within 1 month of OBOT enrollment, and (2) subsequent OBOT program attendance, measured monthly from months 2 to 4 of follow-up. KEY

resultsThe average age was 41.7 years (SD 10.2); 23.6% were female, 35.8% were Hispanic, 12.8% were non-Hispanic Black, and 43.9% were non-Hispanic White. Over one-half (57.4%) were initially engaged. OBOT program attendances during months 2, 3, and 4 were 60.8%, 50.0%, and 41.2%, respectively. One-quarter (24.3%) were initially engaged and then attended the OBOT program every month during the follow-up period. Participants in housing or residential treatment programs (vs. unhoused; adjusted odds ratios (aORs) = 2.52; 95% CI = 1.17-5.44) and those who were already on or initiated a medication for opioid use disorder (OUD) (aOR = 6.53; 95% CI = 1.62-26.25) at the time of OBOT enrollment had higher odds of engagement. Older age (aOR = 1.74 per 10-year increment; 95% CI = 1.28-2.38) and initial engagement (aOR = 3.50; 95% CI = 1.86-6.59) conferred higher odds of attendance.

conclusionsIn this study, over half initially engaged with the OBOT program, with initial engagement emerging as a strong predictor of subsequent OBOT program attendance. Interventions aimed at enhancing initial OBOT program engagement, including those focused on housing and buprenorphine initiation, may improve longer-term outcomes in this marginalized population.

Indexed as

Ambulatory CareIll-Housed PersonsOpioid-Related DisordersAdultAnalgesics, OpioidBostonCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedOpiate Substitution TreatmentOutpatientsProspective StudiesAnalgesics, Opioidopioid use disorder treatmentsubstance use disordersvulnerable populations

Identifiers

PMID38987479
PMCPMC11576663

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.