Improving adherence to HIV quality of care indicators in persons with opioid dependence: The role of buprenorphine

Philip (Todd) Korthuis, David A. Fiellin, Rongwei (Rochelle) Fu, Paula J. Lum, Frederick L. Altice, Nancy Sohler, Mary J. Tozzi, Steven M. Asch, Michael Botsko, Margaret Fishl, Timothy P. Flanigan, Joshua Boverman, Dennis McCarty

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Opioid-dependent HIV-infected patients are less likely to receive HIV quality of care indicators (QIs) compared with nondependent patients. Buprenorphine/naloxone maintenance therapy (bup/nx) could affect the quality of HIV care for opioid-dependent patients. Methods: We abstracted 16 QIs from medical records at nine HIV clinics 12 months before and after initiation of bup/nx versus other treatment for opioid dependence. Summary quality scores (number of QIs received/number eligible × 100) were calculated. We compared change in QIs and summary quality scores in patients receiving bup/nx versus other participants. Results: One hundred ninety-four of 268 participants (72%) received bup/nx and 74 (28%) received other treatment. Mean summary quality scores increased over 12 months for participants receiving bup/nx (45.6% to 51.6%, P <0.001) but not other treatment (48.6% to 47.8%, P = 0.788). Bup/nx participants experienced improvements in six of 16 HIV QIs versus three of 16 QIs in other participants. Improvements were mostly in preventive and monitoring care domains. In multivariable analysis, bup/nx was associated with improved summary quality score (β 8.55; 95% confidence interval, 2.06-15.0). Conclusions: In this observational cohort study, HIV-infected patients with opioid dependence received approximately half of HIV QIs at baseline. Buprenorphine treatment was associated with improvement in HIV QIs at 12 months. Integration of bup/nx into HIV clinics may increase receipt of high-quality HIV care. Further research is required to assess the effect of improved quality of HIV care on clinical outcomes.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
Volume56
Issue numberSUPPL. 1
DOIs
StatePublished - Mar 1 2011

Fingerprint

Buprenorphine
Quality of Health Care
Opioid Analgesics
HIV
Therapeutics
Preventive Medicine
Naloxone Drug Combination Buprenorphine
Medical Records
Observational Studies
Cohort Studies
Confidence Intervals

Keywords

  • buprenorphine
  • health care
  • heroin dependence
  • HIV
  • opioid-related disorders
  • quality indicators
  • quality of health care

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Improving adherence to HIV quality of care indicators in persons with opioid dependence : The role of buprenorphine. / Korthuis, Philip (Todd); Fiellin, David A.; Fu, Rongwei (Rochelle); Lum, Paula J.; Altice, Frederick L.; Sohler, Nancy; Tozzi, Mary J.; Asch, Steven M.; Botsko, Michael; Fishl, Margaret; Flanigan, Timothy P.; Boverman, Joshua; McCarty, Dennis.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 56, No. SUPPL. 1, 01.03.2011.

Research output: Contribution to journalArticle

Korthuis, Philip (Todd) ; Fiellin, David A. ; Fu, Rongwei (Rochelle) ; Lum, Paula J. ; Altice, Frederick L. ; Sohler, Nancy ; Tozzi, Mary J. ; Asch, Steven M. ; Botsko, Michael ; Fishl, Margaret ; Flanigan, Timothy P. ; Boverman, Joshua ; McCarty, Dennis. / Improving adherence to HIV quality of care indicators in persons with opioid dependence : The role of buprenorphine. In: Journal of Acquired Immune Deficiency Syndromes. 2011 ; Vol. 56, No. SUPPL. 1.
@article{21a29918492947dfaf6ebfff7788b890,
title = "Improving adherence to HIV quality of care indicators in persons with opioid dependence: The role of buprenorphine",
abstract = "Background: Opioid-dependent HIV-infected patients are less likely to receive HIV quality of care indicators (QIs) compared with nondependent patients. Buprenorphine/naloxone maintenance therapy (bup/nx) could affect the quality of HIV care for opioid-dependent patients. Methods: We abstracted 16 QIs from medical records at nine HIV clinics 12 months before and after initiation of bup/nx versus other treatment for opioid dependence. Summary quality scores (number of QIs received/number eligible × 100) were calculated. We compared change in QIs and summary quality scores in patients receiving bup/nx versus other participants. Results: One hundred ninety-four of 268 participants (72{\%}) received bup/nx and 74 (28{\%}) received other treatment. Mean summary quality scores increased over 12 months for participants receiving bup/nx (45.6{\%} to 51.6{\%}, P <0.001) but not other treatment (48.6{\%} to 47.8{\%}, P = 0.788). Bup/nx participants experienced improvements in six of 16 HIV QIs versus three of 16 QIs in other participants. Improvements were mostly in preventive and monitoring care domains. In multivariable analysis, bup/nx was associated with improved summary quality score (β 8.55; 95{\%} confidence interval, 2.06-15.0). Conclusions: In this observational cohort study, HIV-infected patients with opioid dependence received approximately half of HIV QIs at baseline. Buprenorphine treatment was associated with improvement in HIV QIs at 12 months. Integration of bup/nx into HIV clinics may increase receipt of high-quality HIV care. Further research is required to assess the effect of improved quality of HIV care on clinical outcomes.",
keywords = "buprenorphine, health care, heroin dependence, HIV, opioid-related disorders, quality indicators, quality of health care",
author = "Korthuis, {Philip (Todd)} and Fiellin, {David A.} and Fu, {Rongwei (Rochelle)} and Lum, {Paula J.} and Altice, {Frederick L.} and Nancy Sohler and Tozzi, {Mary J.} and Asch, {Steven M.} and Michael Botsko and Margaret Fishl and Flanigan, {Timothy P.} and Joshua Boverman and Dennis McCarty",
year = "2011",
month = "3",
day = "1",
doi = "10.1097/QAI.0b013e31820bc9a5",
language = "English (US)",
volume = "56",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "SUPPL. 1",

}

TY - JOUR

T1 - Improving adherence to HIV quality of care indicators in persons with opioid dependence

T2 - The role of buprenorphine

AU - Korthuis, Philip (Todd)

AU - Fiellin, David A.

AU - Fu, Rongwei (Rochelle)

AU - Lum, Paula J.

AU - Altice, Frederick L.

AU - Sohler, Nancy

AU - Tozzi, Mary J.

AU - Asch, Steven M.

AU - Botsko, Michael

AU - Fishl, Margaret

AU - Flanigan, Timothy P.

AU - Boverman, Joshua

AU - McCarty, Dennis

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Background: Opioid-dependent HIV-infected patients are less likely to receive HIV quality of care indicators (QIs) compared with nondependent patients. Buprenorphine/naloxone maintenance therapy (bup/nx) could affect the quality of HIV care for opioid-dependent patients. Methods: We abstracted 16 QIs from medical records at nine HIV clinics 12 months before and after initiation of bup/nx versus other treatment for opioid dependence. Summary quality scores (number of QIs received/number eligible × 100) were calculated. We compared change in QIs and summary quality scores in patients receiving bup/nx versus other participants. Results: One hundred ninety-four of 268 participants (72%) received bup/nx and 74 (28%) received other treatment. Mean summary quality scores increased over 12 months for participants receiving bup/nx (45.6% to 51.6%, P <0.001) but not other treatment (48.6% to 47.8%, P = 0.788). Bup/nx participants experienced improvements in six of 16 HIV QIs versus three of 16 QIs in other participants. Improvements were mostly in preventive and monitoring care domains. In multivariable analysis, bup/nx was associated with improved summary quality score (β 8.55; 95% confidence interval, 2.06-15.0). Conclusions: In this observational cohort study, HIV-infected patients with opioid dependence received approximately half of HIV QIs at baseline. Buprenorphine treatment was associated with improvement in HIV QIs at 12 months. Integration of bup/nx into HIV clinics may increase receipt of high-quality HIV care. Further research is required to assess the effect of improved quality of HIV care on clinical outcomes.

AB - Background: Opioid-dependent HIV-infected patients are less likely to receive HIV quality of care indicators (QIs) compared with nondependent patients. Buprenorphine/naloxone maintenance therapy (bup/nx) could affect the quality of HIV care for opioid-dependent patients. Methods: We abstracted 16 QIs from medical records at nine HIV clinics 12 months before and after initiation of bup/nx versus other treatment for opioid dependence. Summary quality scores (number of QIs received/number eligible × 100) were calculated. We compared change in QIs and summary quality scores in patients receiving bup/nx versus other participants. Results: One hundred ninety-four of 268 participants (72%) received bup/nx and 74 (28%) received other treatment. Mean summary quality scores increased over 12 months for participants receiving bup/nx (45.6% to 51.6%, P <0.001) but not other treatment (48.6% to 47.8%, P = 0.788). Bup/nx participants experienced improvements in six of 16 HIV QIs versus three of 16 QIs in other participants. Improvements were mostly in preventive and monitoring care domains. In multivariable analysis, bup/nx was associated with improved summary quality score (β 8.55; 95% confidence interval, 2.06-15.0). Conclusions: In this observational cohort study, HIV-infected patients with opioid dependence received approximately half of HIV QIs at baseline. Buprenorphine treatment was associated with improvement in HIV QIs at 12 months. Integration of bup/nx into HIV clinics may increase receipt of high-quality HIV care. Further research is required to assess the effect of improved quality of HIV care on clinical outcomes.

KW - buprenorphine

KW - health care

KW - heroin dependence

KW - HIV

KW - opioid-related disorders

KW - quality indicators

KW - quality of health care

UR - http://www.scopus.com/inward/record.url?scp=79951802471&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951802471&partnerID=8YFLogxK

U2 - 10.1097/QAI.0b013e31820bc9a5

DO - 10.1097/QAI.0b013e31820bc9a5

M3 - Article

C2 - 21317600

AN - SCOPUS:79951802471

VL - 56

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - SUPPL. 1

ER -