Chronic High Risk Prescription Opioid Use Among Persons With HIV
Persons with HIV (PWH) are a population at risk for adverse sequelae of opioid use. Yet, few studies have examined correlates of chronic high risk opioid use and its impact on HIV outcomes. Trends in prescribing patterns and identification of factors that impact the use of opioid prescriptions among...
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doaj-de03419f7fe546af88016de42d8429ad2021-05-21T09:31:34ZengFrontiers Media S.A.Frontiers in Sociology2297-77752021-05-01610.3389/fsoc.2021.645992645992Chronic High Risk Prescription Opioid Use Among Persons With HIVAna Ventuneac0Gavriella Hecht1Emily Forcht2Bianca A. Duah3Shafaq Tarar4Blanche Langenbach5Jay Gates6Demetria Cain7H. Jonathon Rendina8H. Jonathon Rendina9Judith A. Aberg10David C. Perlman11Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesDepartment of Psychology, Hunter College, City University of New York, NY, NY, United StatesDepartment of Psychology, Hunter College, City University of New York, NY, NY, United StatesHealth Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesIcahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United StatesPersons with HIV (PWH) are a population at risk for adverse sequelae of opioid use. Yet, few studies have examined correlates of chronic high risk opioid use and its impact on HIV outcomes. Trends in prescribing patterns and identification of factors that impact the use of opioid prescriptions among PWH are crucial to determine prevention and treatment interventions. This study examined electronic medical records (EMR) of patients receiving HIV care to characterize prescribing patterns and identify risk factors for chronic high risk prescription opioid use and the impact on HIV outcomes among PWH in primary care from July 1, 2016–December 31, 2017. EMR were analyzed from 8,882 patients who were predominantly male and ethnically and racially diverse with half being 50 years of age or older. The majority of the 8,744 prescriptions (98% oral and 2% transdermal preparations) given to 1,040 (12%) patients were oxycodone (71%), 8% were morphine, 7% tramadol, 4% hydrocodone, 4% codeine, 2% fentanyl, and 4% were other opioids. The number of monthly prescriptions decreased about 14% during the study period. Bivariate analyses indicated that most demographic and clinical variables were associated with receipt of any opioid prescription. After controlling for patient socio-demographic characteristics and clinical factors, the odds of receipt of any prescription were higher among patients with pain diagnoses and opioid use and mental health disorders. In addition, the odds of receipt of high average daily morphine equivalent dose (MED) prescriptions were higher for patients with pain diagnoses. Lastly, patients with substance use disorders (SUD) had an increased likelihood of detectable viral load compared to patients with no SUD, after adjusting for known covariates. Our findings show that despite opioid prescribing guidelines and monitoring systems, additional efforts are needed to prevent chronic high risk prescriptions in patients with comorbid conditions, including pain-related, mental health and substance use disorders. Evidence about the risk for chronic high risk use based on prescribing patterns could better inform pain management and opioid prescribing practices for patients receiving HIV care.https://www.frontiersin.org/articles/10.3389/fsoc.2021.645992/fullopioid prescriptionmorphine equivalent daily dosechronic opioid therapyHIVviral suppression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ana Ventuneac Gavriella Hecht Emily Forcht Bianca A. Duah Shafaq Tarar Blanche Langenbach Jay Gates Demetria Cain H. Jonathon Rendina H. Jonathon Rendina Judith A. Aberg David C. Perlman |
spellingShingle |
Ana Ventuneac Gavriella Hecht Emily Forcht Bianca A. Duah Shafaq Tarar Blanche Langenbach Jay Gates Demetria Cain H. Jonathon Rendina H. Jonathon Rendina Judith A. Aberg David C. Perlman Chronic High Risk Prescription Opioid Use Among Persons With HIV Frontiers in Sociology opioid prescription morphine equivalent daily dose chronic opioid therapy HIV viral suppression |
author_facet |
Ana Ventuneac Gavriella Hecht Emily Forcht Bianca A. Duah Shafaq Tarar Blanche Langenbach Jay Gates Demetria Cain H. Jonathon Rendina H. Jonathon Rendina Judith A. Aberg David C. Perlman |
author_sort |
Ana Ventuneac |
title |
Chronic High Risk Prescription Opioid Use Among Persons With HIV |
title_short |
Chronic High Risk Prescription Opioid Use Among Persons With HIV |
title_full |
Chronic High Risk Prescription Opioid Use Among Persons With HIV |
title_fullStr |
Chronic High Risk Prescription Opioid Use Among Persons With HIV |
title_full_unstemmed |
Chronic High Risk Prescription Opioid Use Among Persons With HIV |
title_sort |
chronic high risk prescription opioid use among persons with hiv |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Sociology |
issn |
2297-7775 |
publishDate |
2021-05-01 |
description |
Persons with HIV (PWH) are a population at risk for adverse sequelae of opioid use. Yet, few studies have examined correlates of chronic high risk opioid use and its impact on HIV outcomes. Trends in prescribing patterns and identification of factors that impact the use of opioid prescriptions among PWH are crucial to determine prevention and treatment interventions. This study examined electronic medical records (EMR) of patients receiving HIV care to characterize prescribing patterns and identify risk factors for chronic high risk prescription opioid use and the impact on HIV outcomes among PWH in primary care from July 1, 2016–December 31, 2017. EMR were analyzed from 8,882 patients who were predominantly male and ethnically and racially diverse with half being 50 years of age or older. The majority of the 8,744 prescriptions (98% oral and 2% transdermal preparations) given to 1,040 (12%) patients were oxycodone (71%), 8% were morphine, 7% tramadol, 4% hydrocodone, 4% codeine, 2% fentanyl, and 4% were other opioids. The number of monthly prescriptions decreased about 14% during the study period. Bivariate analyses indicated that most demographic and clinical variables were associated with receipt of any opioid prescription. After controlling for patient socio-demographic characteristics and clinical factors, the odds of receipt of any prescription were higher among patients with pain diagnoses and opioid use and mental health disorders. In addition, the odds of receipt of high average daily morphine equivalent dose (MED) prescriptions were higher for patients with pain diagnoses. Lastly, patients with substance use disorders (SUD) had an increased likelihood of detectable viral load compared to patients with no SUD, after adjusting for known covariates. Our findings show that despite opioid prescribing guidelines and monitoring systems, additional efforts are needed to prevent chronic high risk prescriptions in patients with comorbid conditions, including pain-related, mental health and substance use disorders. Evidence about the risk for chronic high risk use based on prescribing patterns could better inform pain management and opioid prescribing practices for patients receiving HIV care. |
topic |
opioid prescription morphine equivalent daily dose chronic opioid therapy HIV viral suppression |
url |
https://www.frontiersin.org/articles/10.3389/fsoc.2021.645992/full |
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