Thakarar Kinna, Kulkarni Amoli, Lodi Sara, Walley Alexander Y, Lira Marlene C, Forman Leah S, Colasanti Jonathan A, Del Rio Carlos, Samet Jeffrey H
Maine Medical Center Research Institute, Boston, MA, USA.
Tufts University School of Medicine, Boston, MA, USA.
J Int Assoc Provid AIDS Care. 2021 Jan-Dec;20:23259582211010952. doi: 10.1177/23259582211010952.
Chronic pain among people with HIV (PWH) is a driving factor of emergency department (ED) utilization, and it is often treated with chronic opioid therapy (COT). We conducted a cross-sectional analysis of a prospective observational cohort of PWH on COT at 2 hospital-based clinics to determine whether COT-specific factors are associated with ED utilization among PWH. The primary outcome was an ED visit within 12 months after study enrollment. We used stepwise logistic regression including age, gender, opioid duration, hepatitis C, depression, prior ED visits, and Charlson comorbidity index. Of 153 study participants, n = 69 (45%) had an ED visit; 25% of ED visits were pain-related. High dose opioids, benzodiazepine co-prescribing, and lack of opioid treatment agreements were not associated with ED utilization, but prior ED visits (p = 0.002), depression (p = 0.001) and higher Charlson comorbidity score (p = 0.003) were associated with ED utilization. COT-specific factors were not associated with increased ED utilization among PWH.
艾滋病毒感染者(PWH)的慢性疼痛是其急诊室(ED)就诊的一个驱动因素,且通常采用慢性阿片类药物治疗(COT)。我们对两家医院门诊接受COT治疗的PWH前瞻性观察队列进行了横断面分析,以确定特定于COT的因素是否与PWH的ED就诊相关。主要结局是研究入组后12个月内的ED就诊。我们使用逐步逻辑回归分析,纳入年龄、性别、阿片类药物使用时长、丙型肝炎、抑郁症、既往ED就诊情况以及查尔森合并症指数。在153名研究参与者中,n = 69(45%)有过ED就诊;25%的ED就诊与疼痛相关。高剂量阿片类药物、苯二氮䓬类药物联合处方以及缺乏阿片类药物治疗协议与ED就诊无关,但既往ED就诊(p = 0.002)、抑郁症(p = 0.001)和较高的查尔森合并症评分(p = 0.003)与ED就诊相关。特定于COT的因素与PWH中ED就诊增加无关。