TY - JOUR
KW - HIV
KW - buprenorphine
KW - Hepatitis C
KW - Naltrexone
KW - opioid use disorders
AU - J. I. Tsui
AU - M. A. Akosile
AU - G. T. Lapham
AU - D. M. Boudreau
AU - E. A. Johnson
AU - J. F. Bobb
AU - I. A. Binswanger
AU - B. J. H. Yarborough
AU - J. E. Glass
AU - R. C. Rossom
AU - M. T. Murphy
AU - C. O. Cunningham
AU - J. H. Arnsten
AU - M. Thakral
AU - A. J. Saxon
AU - J. O. Merrill
AU - J. H. Samet
AU - G. B. Bart
AU - C. I. Campbell
AU - A. M. Loree
AU - A. Silva
AU - A. L. Stotts
AU - B. Ahmedani
AU - J. M. Braciszewski
AU - R. C. Hechter
AU - T. F. Northrup
AU - V. E. Horigian
AU - K. A. Bradley
A1 - 
AB - BACKGROUND: Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. OBJECTIVE: To describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV. DESIGN: Retrospective observational cohort study using electronic health record and insurance data. PARTICIPANTS: Adults ≥ 18 years with ≥ 2 visits to primary care during the study (2014-2016) at 6 healthcare systems across five states (CO, CA, OR, WA, and MN). MAIN MEASURES: The primary outcome was the diagnosis of OUD; the secondary outcome was OUD treatment with buprenorphine or oral/injectable naltrexone. Prevalence of OUD and OUD treatment was calculated across four groups: HCV only; HIV only; HCV and HIV; and neither HCV nor HIV. In addition, adjusted odds ratios (AOR) of OUD treatment associated with HCV and HIV (separately) were estimated, adjusting for age, gender, race/ethnicity, and site. KEY RESULTS: The sample included 1,368,604 persons, of whom 10,042 had HCV, 5821 HIV, and 422 both. The prevalence of diagnosed OUD varied across groups: 11.9% (95% CI: 11.3%, 12.5%) for those with HCV; 1.6% (1.3%, 2.0%) for those with HIV; 8.8% (6.2%, 11.9%) for those with both; and 0.92% (0.91%, 0.94%) among those with neither. Among those with diagnosed OUD, the prevalence of OUD medication treatment was 20.9%, 16.0%, 10.8%, and 22.3%, for those with HCV, HIV, both, and neither, respectively. HCV was not associated with OUD treatment (AOR = 1.03; 0.88, 1.21), whereas patients with HIV had a lower probability of OUD treatment (AOR = 0.43; 0.26, 0.72). CONCLUSIONS: Among patients receiving primary care, those diagnosed with HCV and HIV were more likely to have documented OUD than those without. Patients with HIV were less likely to have documented medication treatment for OUD.
AD - University of Washington/Harborview Medical Center, Seattle, USA.; Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, STE 1600, Seattle, WA, 98101 (206) 948-1933, USA.; Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, STE 1600, Seattle, WA, 98101 (206) 948-1933, USA.; Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, STE 1600, Seattle, WA, 98101 (206) 948-1933, USA.; Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, STE 1600, Seattle, WA, 98101 (206) 948-1933, USA.; Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, STE 1600, Seattle, WA, 98101 (206) 948-1933, USA.; Kaiser Permanente Colorado, Colorado Permanente Medical Group, and the University of Colorado School of Medicine, Aurora, USA.; Kaiser Permanente Northwest Center for Health Research, Portland, USA.; Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, STE 1600, Seattle, WA, 98101 (206) 948-1933, USA.; HealthPartners Institute, University of Minnesota, Bloomington, USA.; MultiCare Institute for Research and Innovation, MultiCare Health System WA, Seattle, USA.; Albert Einstein College of Medicine, Montefiore Medical Center, New York City, USA.; Albert Einstein College of Medicine, Montefiore Medical Center, New York City, USA.; College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, USA.; Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System/University of Washington School of Medicine, Seattle, USA.; University of Washington/Harborview Medical Center, Seattle, USA.; Boston University/Boston Medical Center, Boston, USA.; Hennepin Healthcare, University of Minnesota, Minneapolis, USA.; Division of Research, Kaiser Permanente Northern California, Oakland, USA.; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, USA.; MultiCare Institute fo(TRUNCATED)
BT - Journal of general internal medicine
C5 - Education & Workforce; Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
CP - 4
DO - 10.1007/s11606-020-06389-7
IS - 4
JF - Journal of general internal medicine
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. OBJECTIVE: To describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV. DESIGN: Retrospective observational cohort study using electronic health record and insurance data. PARTICIPANTS: Adults ≥ 18 years with ≥ 2 visits to primary care during the study (2014-2016) at 6 healthcare systems across five states (CO, CA, OR, WA, and MN). MAIN MEASURES: The primary outcome was the diagnosis of OUD; the secondary outcome was OUD treatment with buprenorphine or oral/injectable naltrexone. Prevalence of OUD and OUD treatment was calculated across four groups: HCV only; HIV only; HCV and HIV; and neither HCV nor HIV. In addition, adjusted odds ratios (AOR) of OUD treatment associated with HCV and HIV (separately) were estimated, adjusting for age, gender, race/ethnicity, and site. KEY RESULTS: The sample included 1,368,604 persons, of whom 10,042 had HCV, 5821 HIV, and 422 both. The prevalence of diagnosed OUD varied across groups: 11.9% (95% CI: 11.3%, 12.5%) for those with HCV; 1.6% (1.3%, 2.0%) for those with HIV; 8.8% (6.2%, 11.9%) for those with both; and 0.92% (0.91%, 0.94%) among those with neither. Among those with diagnosed OUD, the prevalence of OUD medication treatment was 20.9%, 16.0%, 10.8%, and 22.3%, for those with HCV, HIV, both, and neither, respectively. HCV was not associated with OUD treatment (AOR = 1.03; 0.88, 1.21), whereas patients with HIV had a lower probability of OUD treatment (AOR = 0.43; 0.26, 0.72). CONCLUSIONS: Among patients receiving primary care, those diagnosed with HCV and HIV were more likely to have documented OUD than those without. Patients with HIV were less likely to have documented medication treatment for OUD.
PY - 2021
SN - 1525-1497; 0884-8734; 0884-8734
SP - 930
EP - 937
EP - 
T1 - Prevalence and Medication Treatment of Opioid Use Disorder Among Primary Care Patients with Hepatitis C and HIV
T2 - Journal of general internal medicine
TI - Prevalence and Medication Treatment of Opioid Use Disorder Among Primary Care Patients with Hepatitis C and HIV
U1 - Education & Workforce; Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
U2 - 33569735
U3 - 10.1007/s11606-020-06389-7
VL - 36
VO - 1525-1497; 0884-8734; 0884-8734
Y1 - 2021
Y2 - Apr
ER -