{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:54:53Z","timestamp":1790686493128,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Shared medical appointments (SMAs) integrate group-based clinical care with individual medical management and are increasingly used in the treatment of substance use disorders (SUDs) to improve access, engagement, and care coordination. However, their use, outcomes, and implementation in SUD care have not been systematically synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a systematic review registered with PROSPERO (CRD42025639504). MEDLINE, Embase, PsycINFO, Scopus, and Cochrane Central were searched from database inception through September 2025. Randomized controlled trials, observational studies, and qualitative studies examining SMAs among adults with SUDs were included. Outcomes of interest included treatment engagement and retention, substance use outcomes, mental health and patient-reported outcomes, and implementation characteristics. Study quality was assessed across quantitative and qualitative designs, and findings were synthesized descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fourteen studies, representing approximately 578 participants, met inclusion criteria. Twelve studies focused exclusively on opioid use disorder, 1 included both alcohol and opioid use disorders, and 1 did not specify substance type. Treatment retention was reported in 6 studies, with a median 6-month retention of 72.9%. Three studies reported reductions in substance use outcomes, and 2 reported improvements in depression or anxiety. Qualitative studies consistently described high patient satisfaction, peer support, and shared accountability. Implementation studies demonstrated feasibility across diverse outpatient settings, with substantial heterogeneity across study designs and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SMAs appear feasible and acceptable for addiction care and may support treatment retention and patient experience. Evidence remains heterogeneous and largely observational, highlighting the need for rigorous comparative studies to better define effectiveness and implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342261457248","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:44:36Z","timestamp":1784004276000},"page":"1288-1296","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shared Medical Appointments for Substance Use Disorders: A Systematic Review"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0308-3481","authenticated-orcid":false,"given":"Kush","family":"Sehgal","sequence":"first","affiliation":[{"name":"Teerthanker Mahaveer Medical College &amp; Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6096-971X","authenticated-orcid":false,"given":"Ana Carolina","family":"Leal","sequence":"additional","affiliation":[{"name":"IDOMED University, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia Mara dos Santos","family":"Barbetta","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8391-4785","authenticated-orcid":false,"given":"Neil","family":"Nero","sequence":"additional","affiliation":[{"name":"Education Institute, Floyd D. Loop Alumni Library, Cleveland Clinic, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Cleveland Clinic, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"World Health Organization. Opioid Overdose. Updated August 29 2025. Accessed January 15 2026. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/opioid-overdose"},{"key":"e_1_3_2_3_2","unstructured":"United Nations Office on Drugs and Crime. World Drug Report 2025. 2025. Accessed January 15 2026. https:\/\/www.unodc.org\/unodc\/data-and-analysis\/world-drug-report-2025.html"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21073"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_1309_15"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2013.07.007"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108422"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1929"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2064-z"},{"key":"e_1_3_2_10_2","volume-title":"VA Evidence-Based Synthesis Program Reports. Shared Medical Appointments for Chronic Medical Conditions: A Systematic Review","author":"Edelman D","year":"2012","unstructured":"Edelman D, McDuffie JR, Oddone E, Gierisch JM, Nagi A, Williams JWJr. VA Evidence-Based Synthesis Program Reports. Shared Medical Appointments for Chronic Medical Conditions: A Systematic Review. Department of Veterans Affairs (US); 2012."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-067252"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000071"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2014.998400"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2015.05.150017"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/29767342241233363"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_2_17_2","unstructured":"Covidence Systematic Review Software. Veritas Health Innovation. Melbourne Australia; 2025. Accessed December 5 2025. https:\/\/www.covidence.org"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2019.03.008"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.2010258"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2016.1264535"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05890-3"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000912"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2022.2123669"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.1876202"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-025-00540-7"},{"issue":"1","key":"e_1_3_2_26_2","first-page":"47","article-title":"A shared medical appointment (SMA) model for U.S. veterans treated with buprenorphine in an outpatient setting: an appraisal of mortality, risk, and protective factors","volume":"23","author":"Phelan J. E.","year":"2021","unstructured":"Phelan J. E. A shared medical appointment (SMA) model for U.S. veterans treated with buprenorphine in an outpatient setting: an appraisal of mortality, risk, and protective factors. Heroin Addict Relat Clin Probl. 2021;23(1):47-55.","journal-title":"Heroin Addict Relat Clin Probl"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2017.1356792"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1635958"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2022.0696"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000166"},{"key":"e_1_3_2_31_2","unstructured":"Substance Abuse and Mental Health Services Administration. Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals Policymakers Patients and Families. Treatment Improvement Protocol (TIP) Series No 63. 2021. 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