The Integrated Mobile Opioid Treatment and Infectious Disease Coordinated Care in Your Neighborhood (InMOTION) program is an innovative mobile retail pharmacy and clinic (MPC) located in Connecticut. The InMOTION MPC program uses a multidisciplinary team of clinicians, pharmacists and community health workers (CHWs) who provide integrated clinical and on-site pharmacy services to people who use drugs in communities with high rates of overdose. Findings from a recent study show that the InMOTION MPC program engaged with 414 individuals over an 11-month period and delivered integrated care for substance use disorders (SUDs), infectious diseases and needs related to the social determinants of health using a mobile platform.
Program description
InMOTION is the first legal MPC program in the United States that integrates retail pharmacy and mobile health clinic care services for people who use drugs. In May 2024, legislation was passed in Connecticut that legalized mobile retail pharmacies and authorized a wider scope of practice for pharmacists.
By removing transportation barriers and offering services where people are located (e.g., encampments, shelters, other underserved locations), the InMOTION MPC team provides integrated clinical and pharmacy care to people who use drugs in communities with high rates of overdose. The MPC team includes a clinician, a driver, a pharmacist, three CHWs and a medical technician trained in phlebotomy (blood tests) who also works as a CHW.
The clinician provides vaccines, administers medications, conducts HIV and hepatitis C tests, offers telehealth services and in-person assessments, provides clinical evaluations and writes prescriptions.
The pharmacist administers vaccines, provides medication counselling, performs HIV and hepatitis C testing, delivers telehealth and in-person clinical services, and offers overdose prevention education and prescribes naloxone. The pharmacist dispenses medications after receiving electronic prescriptions submitted through telehealth or by the MPC clinician on-site, as well as prescriptions from other licensed providers in the community.
The CHWs offer overdose prevention and harm reduction education, conduct screenings for SUDs (e.g., opioid use disorder [OUD], stimulant use disorder [StUD], alcohol use disorder [AUD]), perform rapid HIV and hepatitis C antibody testing, evaluate clients for eligibility for pre-exposure prophylaxis (PrEP) and assess clients for non-communicable diseases (e.g., blood pressure, finger-stick blood glucose evaluations). The CHWs also help clients to complete applications for insurance, food assistance and other benefits, provide transportation and access to telehealth tablets, and deliver services and medications to clients where they are located in the community. The CHWs reduce stigma by interacting with community members to identify needs related to the social determinants, address barriers to care and facilitate community outreach and linkage to clinicians in-person on the MPC, via telehealth or via referrals to local community clinics and social services.
Using data from Connecticut Department of Public Health and input from community partners, the MPC team identifies where to go in the community four days a week between 9 a.m. and 2 p.m. The mobile pharmacy is stocked with medications for many medical conditions, including antibiotics, vaccines, HIV PrEP, medications for SUDs, medications to treat sexually transmitted and blood-borne infections (STBBIs) and doxycycline for post-exposure prophylaxis (doxy-PEP). The pharmacist, clinician, medical technician and CHWs work together to arrange follow-up care and prescription refills for clients.
Results
Between December 2023 and November 2024, study participants were enrolled from three towns in Connecticut with an identified high need for medical and social services. During the first 11 months of the project, 414 people engaged in services with the MPC team for a total of 543 medical appointments. Of these appointments, 85% (463 visits) were in-person, and the remaining 15% of visits (85) were via telehealth. Of the 414 people who participated, 43% identified as women, 26% identified as Black/African American, 45% identified as Hispanic, 32% were uninsured and 37% were unhoused or unstably housed.
HIV, hepatitis C and other STBBIs
Of the 414 participants who engaged with the MPC team, four people (1%) had a previous HIV diagnosis. A total of 166 of 410 people (41%) without a previous diagnosis accepted rapid HIV testing, and one of these people (1%) received a new HIV diagnosis. All five of the individuals living with HIV received antiretroviral therapy from the MPC. Nine people (6%) who tested negative for HIV accepted new HIV PrEP prescriptions.
Twenty-two people (22/414; 5%) had a previous hepatitis C diagnosis, 157 of the 392 people (40%) without a previous diagnosis accepted rapid point-of-care hepatitis C antibody testing and nine out of 157 people (6%) tested positive for hepatitis C antibodies. Of the 31 participants with a new or previous diagnosis, 11 accepted confirmatory testing on the same day as antibody testing; nine had a detectable viral load and eight went on to start treatment through the MPC.
Of the nine people (9/414; 2%) who engaged in STBBI testing (i.e., those who expressed concerns about an exposure to an STBBI), three people (33%) had positive results; all were prescribed treatment and one person (11%) received doxy-PEP from the MPC.
SUDs, overdose prevention and other harm reduction services
Of the 414 participants who engaged with the MPC team, 51 (12%) had a previous diagnosis of OUD. A total of 163 out of 363 people (45%) without a previous OUD diagnosis were screened for OUD; there was one (1/163; 1%) new moderate-to-severe OUD diagnosis. Of the 52 people with previous or new diagnoses of OUD, 37 (71%) were prescribed medications for OUD (e.g., methadone) from non-MPC providers and five (10%) were prescribed medications for OUD by MPC providers.
Twenty-four people (24/414; 6%) had a previous diagnosis of AUD and 147 of the 390 people (38%) without an AUD diagnosis accepted screening for AUD, resulting in six (6/147; 4%) new moderate-to-severe AUD diagnoses. Of the 30 participants with previous or new diagnoses of AUD, eleven (11/30; 37%) were prescribed a medication to treat their AUD (e.g., oral and extended-release injectable naltrexone, acamprosate) through the MPC.
Twenty-seven participants (27/414; 7%) had a previous diagnosis of StUD and 175 of 387 people (45%) accepted screening for StUD. Of those screened for StUD, 10 out of 175 (6%) had a new diagnosis of moderate-to-severe StUD and were referred to substance use programs in the community.
Overall, 35 people accepted and received overdose prevention education and naloxone distribution, 15 people accessed fentanyl test strips, 18 people accessed xylazine test strips and six people were treated for xylazine-related wounds.
What does this mean for service providers?
The InMOTION MPC model of care offers the opportunity to reduce barriers on an individual level and fill gaps at the community level by engaging communities with high rates of overdose. Results demonstrate the potential of this fully integrated healthcare model to address the intersections of SUDs, infectious diseases and social determinants of health in a unique mobile platform that goes to communities with a high need for services. By meeting participants where they were located, the MPC successfully engaged a wide range of people often underserved by traditional healthcare systems, including people who were unhoused or unstably housed, people who were uninsured, and people with diverse gender, ethnic and racial backgrounds. With the convenience of an on-site clinic and pharmacy, the MPC team collaborated to provide same-day access to treatments that clients may not generally be aware of or have timely access to.
Related resources
Mobile Outreach Street Health (MOSH) Clinic – CATIE case study
Community pop-up clinics – CATIE case study
A flexible and mobile approach to hepatitis C care delivery for people experiencing homelessness – CATIE article
Mobile Withdrawal Management Service – CATIE article
Reference
Tarfa A, Di Paola A, Frank CA et al. Pilot findings from the first legalized mobile retail pharmacy clinic in the United States for infectious disease treatment and prevention tailored to reach people who use drugs. Open Forum Infectious Diseases. 2025;12(4):ofaf200. https://doi.org/10.1093/ofid/ofaf200