Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV.
Treatment of opioid use disorder (OUD) with buprenorphine improves outcomes and mortality among people with HIV (PWH). However, engagement is low and is influenced by comorbidities. We examined the impact of patterns of co-occurring pain, substance use disorders (SUDs), and mental health diagnoses o...
| Publicado en: | AIDS & Behavior Vol. 28; no. 12; pp. 3994 - 4005 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181065278&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181065278 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10907165 G1T jtl: AIDS & Behavior issn: 10907165 maglogo: N pubinfo: dt: Dec2024 vid: 28 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 181065278 179588299 181065278 181065278 10.1007/s10461-024-04494-w 181065278 ppf: 3994 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV. aug: au: Miller, Emily A. McGinnis, Kathleen A. Edelman, E. Jennifer Feinberg, Termeh Gordon, Kirsha S. Kerns, Robert D. Marshall, Brandon D. L. Patterson, Julie A. McRae, MaryPeace affil: https://ror.org/02nkdxk79 Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA sug: subj: HIV Infections Drug Therapy HIV Infections Epidemiology Buprenorphine Therapeutic Use Pain Drug Therapy Mental Health Evaluation Mental Disorders Drug Therapy Substance Use Disorders Drug Therapy Substance Use Disorders Epidemiology Pain Epidemiology Treatment Outcomes Human Funding Source Male Female United States Prospective Studies Nonexperimental Studies Structural Equation Modeling Veterans International Classification of Diseases Comorbidity Aging Regression Prescriptions, Drug HIV-Positive Persons Psychosocial Factors Analgesics, Opioid Therapeutic Use HIV Infections Complications Mental Disorders Complications Descriptive Statistics Male Female ab: Treatment of opioid use disorder (OUD) with buprenorphine improves outcomes and mortality among people with HIV (PWH). However, engagement is low and is influenced by comorbidities. We examined the impact of patterns of co-occurring pain, substance use disorders (SUDs), and mental health diagnoses on buprenorphine initiation and retention in PWH. The Veterans Aging Cohort Study contained 7,875 patients (2,702 PWH and 5,173 without HIV) with new OUD clinical encounters (2008–2017). Buprenorphine initiation and retention were derived from prescription data. We identified patterns of co-occurring diagnoses (via ICD codes) and assessed the effects of class membership on both outcomes using latent class analysis and regression analyses. The mean age of patients was 55, 98% were male, 58% Black, 8% Hispanic, and only 8% initiated buprenorphine within 12 months of OUD diagnosis. Four classes of co-occurring diagnoses were identified: "Few Co-occurring Diagnoses" (42.3%); "Multiple Pain Conditions" (21.3%); "Pain + SUD" (18.4%) and "Pain + SUD + Mental Health" (18.0%). Patients in the "Pain + SUD" class and "Pain + SUD + Mental Health" class were significantly less likely to initiate buprenorphine and had 59% and 45% lower odds, respectively, of initiating buprenorphine compared with patients in the "Few Co-occurring Diagnoses" class; this effect did not vary by HIV status. Buprenorphine retention was not significantly associated with HIV status or class membership. However, Black Veterans were less likely to initiate or be retained in buprenorphine treatment. Higher comorbidity burden was negatively associated with buprenorphine initiation but not with retention. More research is warranted to determine other factors that may influence treatment retention. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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