| Outpatient patterns of care and longitudinal intensity of antiretroviral therapy for HIV-infected drug users. | |
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MedLine Citation:
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PMID: 12395030 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Christine Laine; Walter W Hauck; Barbara J Turner |
Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Medical care Volume: 40 ISSN: 0025-7079 ISO Abbreviation: Med Care Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-10-23 Completed Date: 2002-11-05 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0230027 Medline TA: Med Care Country: United States |
Other Details:
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Languages: eng Pagination: 976-95 Citation Subset: IM |
Affiliation:
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Division of Internal Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01 DA11606/DA/NIDA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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