Journal of the International Association of Providers of AIDS Care (Apr 2021)

Emergency Department Utilization Among People Living With HIV on Chronic Opioid Therapy

  • Kinna Thakarar DO, MPH,
  • Amoli Kulkarni BA,
  • Sara Lodi PhD,
  • Alexander Y. Walley MD, MSc,
  • Marlene C. Lira MPH,
  • Leah S. Forman MPH,
  • Jonathan A. Colasanti MD, MSPH,
  • Carlos del Rio MD,
  • Jeffrey H. Samet MD, MA, MPH

DOI
https://doi.org/10.1177/23259582211010952
Journal volume & issue
Vol. 20

Abstract

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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.