Thakarar K, Walley A Y, Heeren T C, Winter M R, Ventura A S, Sullivan M, Drainoni M, Saitz R
Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, USA.
Tufts University School of Medicine, Boston, MA, USA.
AIDS Care. 2020 Sep;32(9):1177-1181. doi: 10.1080/09540121.2019.1683805. Epub 2019 Nov 5.
Medication for addiction treatment (MAT) could reduce acute care utilization in HIV-positive individuals with substance use disorders. The study objective was to determine if HIV-positive people with substance use disorders treated with MAT report less acute care utilization than those not receiving MAT. We assessed the association between MAT and acute care utilization among HIV-positive individuals with alcohol or opioid use disorder. Acute care utilization 6 months later was defined as any past 3-month self-reported (1) emergency department (ED) visit and (2) hospitalization. Of 153 participants, 88% had alcohol use disorder, 41% had opioid use disorder, and 48 (31%) were treated with MAT. Fifty-five (36%) participants had an ED visit and 38 (25%) participants had a hospitalization. MAT was not associated with an ED visit (AOR 1.12, 95% CI 0.46-2.75) or hospitalization (AOR 1.09, 95% CI 0.39-3.04). MAT was not associated with acute care utilization. These results highlight the need to increase MAT prescribing in HIV-positive individuals with substance use disorders, and to address the many factors that influence acute care utilization.
药物成瘾治疗（MAT）可降低患有物质使用障碍的HIV阳性个体的急症护理利用率。本研究的目的是确定接受MAT治疗的患有物质使用障碍的HIV阳性患者与未接受MAT治疗的患者相比，急症护理利用率是否更低。我们评估了MAT与患有酒精或阿片类物质使用障碍的HIV阳性个体的急症护理利用率之间的关联。6个月后的急症护理利用率定义为过去3个月内自我报告的任何（1）急诊就诊和（2）住院情况。在153名参与者中，88%患有酒精使用障碍，41%患有阿片类物质使用障碍，48名（31%）接受了MAT治疗。55名（36%）参与者有急诊就诊，38名（25%）参与者有住院治疗。MAT与急诊就诊（调整后比值比[AOR]为1.12，95%置信区间[CI]为0.46 - 2.75）或住院治疗（AOR为1.09，95% CI为0.39 - 3.04）均无关联。MAT与急症护理利用率无关。这些结果凸显了有必要增加对患有物质使用障碍的HIV阳性个体开具MAT处方，并应对影响急症护理利用率的诸多因素。
