Document Detail


Outpatient patterns of care and longitudinal intensity of antiretroviral therapy for HIV-infected drug users.
MedLine Citation:
PMID:  12395030     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the association of drug users' outpatient patterns of care with subsequent intensity of antiretroviral therapy (ART). MATERIALS AND METHODS: Annual types of ART in 8897 New York State Medicaid drug users who were prescribed ART for > or =6 months in 1996 or 1997 were determined. From pharmacy claims, intensity was classified from changes in annual type of ART in 1996 to 97 and 1997 to 98 as: optimal (ie, on or starting highly active ART [HAART]), acceptable (ie, on or starting 2+ non-HAART drugs), or suboptimal (ie, none, <6 months, one drug, or change from HAART to non-HAART). In both 1996 and 1997, outpatient pattern of care was defined including regular medical care, regular drug treatment, both, and neither and categories of visits for HIV-focused care. Predictors of adequate ART intensity were examined among the group with suboptimal or adequate intensity (model 1) and predictors of optimal ART intensity among the group with adequate or optimal intensity (model 2). RESULTS: The adjusted odds ratios (AOR) of acceptable ART intensity in model 1 were increased for those with HIV-focused care (AOR, 2.9; 95% CI, 2.6, 3.3 for 4+ visits 1.7; 95% CI, 1.5, 1.9 for 1-3 visits) or regular medical care (AOR, 1.2 [1.1, 1.4]. Adjusted odds ratios (AOR) of optimal intensity in model 2 were increased for those with regular substance abuse care with (AOR, 1.4 [1.2, 1.7]) or without (AOR, 1.2 [1.1, 1.4]) regular medical care whereas HIV-focused visits had no effect. CONCLUSION: Care from an HIV-focused provider was predictive of a drug user receiving at least adequate intensity of ART for more than 2 years whereas regular drug abuse treatment, especially with regular medical care, was associated with optimal intensity of ART.
Authors:
Christine Laine; Walter W Hauck; Barbara J Turner
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Medical care     Volume:  40     ISSN:  0025-7079     ISO Abbreviation:  Med Care     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-23     Completed Date:  2002-11-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  976-95     Citation Subset:  IM    
Affiliation:
Division of Internal Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Ambulatory Care / methods*,  trends
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active / utilization*
Cohort Studies
Confidence Intervals
Drug Therapy, Combination
Drug Utilization Review / statistics & numerical data*
Female
HIV Infections / drug therapy*
Humans
Male
Medicaid
Middle Aged
New York
Physician's Practice Patterns / statistics & numerical data*
Regression Analysis
Retrospective Studies
Substance-Related Disorders / complications*
Grant Support
ID/Acronym/Agency:
R01 DA11606/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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