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

P. Todd Korthuis, David A. Fiellin, Rongwei 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

36 Scopus citations

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)
Pages (from-to)S83-S90
JournalJournal of Acquired Immune Deficiency Syndromes
Volume56
Issue numberSUPPL. 1
DOIs
StatePublished - Mar 1 2011

    Fingerprint

Keywords

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

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Korthuis, P. T., Fiellin, D. A., Fu, R., Lum, P. J., Altice, F. L., Sohler, N., Tozzi, M. J., Asch, S. M., Botsko, M., Fishl, M., Flanigan, T. P., Boverman, J., & McCarty, D. (2011). Improving adherence to HIV quality of care indicators in persons with opioid dependence: The role of buprenorphine. Journal of Acquired Immune Deficiency Syndromes, 56(SUPPL. 1), S83-S90. https://doi.org/10.1097/QAI.0b013e31820bc9a5