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Measuring time in buprenorphine treatment stages among people with HIV and opioid use disorder by retention definition and its association with cocaine and hazardous alcohol use.
Pytell, Jarratt D; Fojo, Anthony T; Keruly, Jeanne C; Snow, LaQuita N; Falade-Nwulia, Oluwaseun; Moore, Richard D; Chander, Geetanjali; Lesko, Catherine R.
Afiliación
  • Pytell JD; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Mail Stop B180, 12631 E. 17Th Ave, Aurora, CO, 80045, USA. Jarratt.Pytell@cuanschutz.edu.
  • Fojo AT; Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  • Keruly JC; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Snow LN; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Falade-Nwulia O; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Moore RD; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Chander G; Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA.
  • Lesko CR; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Addict Sci Clin Pract ; 18(1): 51, 2023 09 02.
Article en En | MEDLINE | ID: mdl-37660116
BACKGROUND: We use a novel, longitudinal approach to describe average time spent in opioid use disorder (OUD) cascade of care stages for people with HIV (PWH) and with OUD, incorporating four definitions of treatment retention. Using this approach, we describe the impact of cocaine or hazardous alcohol use on time spent retained on buprenorphine. METHODS: We followed PWH with OUD enrolled in the Johns Hopkins HIV Clinical Cohort from their first buprenorphine treatment episode between 2013 and 2020. We estimated 4-year restricted mean time spent on buprenorphine below buprenorphine retention threshold, on buprenorphine above retention threshold, off buprenorphine and in HIV care, loss to follow-up, and death. Retention definitions were based on retention threshold (180 vs 90 days) and allowable treatment gap (7 vs 30 days). Differences in 2-year restricted mean time spent retained on buprenorphine were estimated for patients with and without cocaine or hazardous alcohol use. RESULTS: The study sample (N = 179) was 63% male, 82% non-Hispanic Black, and mean age was 53 (SD 8) years. Patients spent on average 13.9 months (95% CI 11.4, 16.4) on buprenorphine over 4 years. There were differences in time spent retained on buprenorphine based on the retention definition, ranging from 6.5 months (95% CI 4.6, 8.5) to 9.6 months (95% CI 7.4, 11.8). Patients with cocaine use spent fewer months retained on buprenorphine. There were no differences for patients with hazardous alcohol use. CONCLUSIONS: PWH with OUD spend relatively little time receiving buprenorphine in their HIV primary care clinic. Concurrent cocaine use at buprenorphine initiation negatively impact time on buprenorphine.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Buprenorfina / Infecciones por VIH / Cocaína / Trastornos Relacionados con Cocaína / Trastornos Relacionados con Opioides Tipo de estudio: Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Addict Sci Clin Pract Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Buprenorfina / Infecciones por VIH / Cocaína / Trastornos Relacionados con Cocaína / Trastornos Relacionados con Opioides Tipo de estudio: Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Addict Sci Clin Pract Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido