• J. Acquir. Immune Defic. Syndr. · Mar 2011

    Improving adherence to HIV quality of care indicators in persons with opioid dependence: the role of buprenorphine.

    • P Todd Korthuis, David A Fiellin, Rongwei Fu, Paula J Lum, Frederick L Altice, Nancy Sohler, Mary J Tozzi, Steven M Asch, Michael Botsko, Margaret Fishl, Timothy P Flanigan, Joshua Boverman, Dennis McCarty, and BHIVES Collaborative.
    • Department of Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA. korthuis@ohsu.edu
    • J. Acquir. Immune Defic. Syndr. 2011 Mar 1;56 Suppl 1:S83-90.

    BackgroundOpioid-dependent HIV-infected patients are less likely to receive HIV quality of care indicators (QIs) compared with nondependent patients. Buprenorphine/naloxone maintenance therapy (bup/nx) could affect the quality of HIV care for opioid-dependent patients.MethodsWe abstracted 16 QIs from medical records at nine HIV clinics 12 months before and after initiation of bup/nx versus other treatment for opioid dependence. Summary quality scores (number of QIs received/number eligible × 100) were calculated. We compared change in QIs and summary quality scores in patients receiving bup/nx versus other participants.ResultsOne hundred ninety-four of 268 participants (72%) received bup/nx and 74 (28%) received other treatment. Mean summary quality scores increased over 12 months for participants receiving bup/nx (45.6% to 51.6%, P < 0.001) but not other treatment (48.6% to 47.8%, P = 0.788). Bup/nx participants experienced improvements in six of 16 HIV QIs versus three of 16 QIs in other participants. Improvements were mostly in preventive and monitoring care domains. In multivariable analysis, bup/nx was associated with improved summary quality score (β 8.55; 95% confidence interval, 2.06-15.0).ConclusionsIn this observational cohort study, HIV-infected patients with opioid dependence received approximately half of HIV QIs at baseline. Buprenorphine treatment was associated with improvement in HIV QIs at 12 months. Integration of bup/nx into HIV clinics may increase receipt of high-quality HIV care. Further research is required to assess the effect of improved quality of HIV care on clinical outcomes.

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