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Abstract
The factors associated with chronic opioid therapy (COT) in patients with HIV is understudied. Using Medicaid data (2002–2009), this retrospective cohort study examines COT in beneficiaries with HIV who initiated standard combination anti-retroviral therapy (cART). We used generalized estimating equations on logistic regression models with backward selection to identify significant predictors of COT initiation. COT was initiated among 1014 out of 9615 beneficiaries with HIV (male: 10.4%; female: 10.7%). Those with older age, any malignancy, Hepatitis C infection, back pain, arthritis, neuropathy pain, substance use disorder, polypharmacy, (use of) benzodiazepines, gabapentinoids, antidepressants, and prior opioid therapies were positively associated with COT. In sex-stratified analyses, multiple predictors were shared between male and female beneficiaries; however, chronic obstructive pulmonary disease, liver disease, any malignancy, and antipsychotic therapy were unique to female beneficiaries. Comorbidities and polypharmacy were important predictors of COT in Medicaid beneficiaries with HIV who initiated cART.
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1 University of Kentucky, Department of Epidemiology, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky, Department of Pharmacy Practice and Science, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky College of Pharmacy, Institute for Pharmaceutical Outcomes and Policy, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438)
2 University of Kentucky, Department of Pharmacy Practice and Science, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); Takeda Pharmaceuticals, Cambridge, USA (GRID:grid.266539.d)
3 University of Kentucky, Department of Epidemiology, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky, Sanders-Brown Center on Aging, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky, Department of Biostatistics, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438)
4 University of Kentucky, Sanders-Brown Center on Aging, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky, Department of Biostatistics, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438)
5 University of Kentucky, Department of Pharmacy Practice and Science, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky College of Pharmacy, Institute for Pharmaceutical Outcomes and Policy, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438)
6 University of Kentucky, Department of Epidemiology, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky, Department of Pharmacy Practice and Science, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky College of Pharmacy, Institute for Pharmaceutical Outcomes and Policy, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438); University of Kentucky, Sanders-Brown Center on Aging, Lexington, USA (GRID:grid.266539.d) (ISNI:0000 0004 1936 8438)