Buprenorphine Maintenance Treatment Retention Improves Nationally Recommended Preventive Primary Care Screenings when Integrated into Urban Federally Qualified Health Centers.
Buprenorphine maintenance therapy (BMT) expands treatment access for opioid dependence and can be integrated into primary health-care settings. Treating opioid dependence, however, should ideally improve other aspects of overall health, including preventive services. Therefore, we examined how BMT a...
| Publicado en: | Journal of Urban Health Vol. 92; no. 1; pp. 193 - 214 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Springer Nature
Feb2015
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=101114172&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 101114172 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10993460 GMF jtl: Journal of Urban Health issn: 10993460 maglogo: N pubinfo: dt: Feb2015 vid: 92 iid: 1 pid: 237 pub: Springer Nature artinfo: ui: 101114172 10.1007/s11524-014-9924-1 ppf: 193 ppct: 21 formats: fmt: @attributes: type: P size: 396KB tig: atl: Buprenorphine Maintenance Treatment Retention Improves Nationally Recommended Preventive Primary Care Screenings when Integrated into Urban Federally Qualified Health Centers. aug: au: Altice, Frederick Haddad, Marwan Zelenev, Alexei affil: Community Health Center, Inc., 635 Main Street Middletown 06457 USA Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven USA su: Substance abuse Addictions Health facilities Buprenorphine Opioid abuse Medical centers sug: subj: Substance abuse Addictions Health facilities All Other Outpatient Care Centers HMO Medical Centers Buprenorphine Opioid abuse Medical centers keyword: Addiction Federally qualified health centers Health disparities Health-care utilization Implementation science Integrated care Opioid dependence Preventive screening Primary care Quality health-care indicators Women Addiction Federally qualified health centers Health disparities Health-care utilization Implementation science Integrated care Opioid dependence Preventive screening Primary care Quality health-care indicators Women ab: Buprenorphine maintenance therapy (BMT) expands treatment access for opioid dependence and can be integrated into primary health-care settings. Treating opioid dependence, however, should ideally improve other aspects of overall health, including preventive services. Therefore, we examined how BMT affects preventive health-care outcomes, specifically nine nationally recommended primary care quality health-care indicators (QHIs), within federally qualified health centers (FQHCs) from an observational cohort study of 266 opioid-dependent patients initiating BMT between 07/01/07 and 11/30/08 within Connecticut's largest FQHC network. Nine nationally recommended preventive QHIs were collected longitudinally from electronic health records, including screening for chronic infections, metabolic conditions, and cancer. A composite QHI score (QHI-S), based on the percentage of eligible QHIs achieved, was categorized as QHI-S ≥80 % (recommended) and ≥90 % (optimal). The proportion of subjects achieving a composite QHI-S ≥80 and ≥90 % was 57.1 and 28.6 %, respectively. Screening was highest for hypertension (91.0 %), hepatitis C (80.1 %), hepatitis B (76.3 %), human immunodeficiency virus (71.4 %), and hyperlipidemia (72.9 %) and lower for syphilis (49.3 %) and cervical (58.5 %), breast (44.4 %), and colorectal (48.7 %) cancer. Achieving QHI-S ≥80 % was positively and independently associated with ≥3-month BMT retention (adjusted odds ratio (AOR) = 2.19; 95 % confidence interval (CI) = 1.18-4.04) and BMT prescription by primary care providers (PCPs) rather than addiction psychiatric specialists (AOR = 3.38; 95 % CI = 1.78-6.37), and negatively with being female (AOR = 0.30; 95 % CI = 0.16-0.55). Within primary health-care settings, achieving greater nationally recommended health-care screenings or QHIs was associated with being able to successfully retain patients on buprenorphine longer (3 months or more) and when buprenorphine was prescribed simultaneously by PCPs rather than psychiatric specialists. Decreased preventive screening for opioid-dependent women, however, may require gender-based strategies for achieving health-care parity. When patients can be retained, integrating BMT into urban FQHCs is associated with improved health outcomes including increased multiple preventive health-care screenings. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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