Shared Medical Appointments Role in the Opioid Epidemic Era: A Tool forIntegration of Care

Medical visits encompass multiple medical issues, leaving little time to address substance use disorder issues, such as medication-assisted treatment (MAT) for opioid use disorders (OUD). This becomes a barrier to expanding Office-Based Opioid Treatment (OBOT), as many physicians express concern about treating high-risk patients under the current time constrained treatment model. Evidence shows that shared medical appointments (SMAs) are effective treatment models that increase health outcomes and are well received by patients. Research studies that come from primary care where large patient panels and limited access have necessitated the creation of innovative and efficient care delivery. Substance use disorders (SUDs) are chronic diseases comparable to diabetes and hypertension with similar treatment outcomes. Group therapy is well established as an effective, evidence-based treatment for SUDs. Using the SMA model with elements of group therapy to provide OBOT allows physicians to spend more time with their patients, albeit in a group setting. SMA for OBOT will allow these physicians more time with high-risk patients. When done with elements of group therapy, SMAs can provide quality and cost-effective treatment. This manuscript will provide an overview of the scope of the current opioid problem, current treatment practices and barriers to treatment as well as guidelines on how to implement SMA model in an integrated care setting.