1. Economic and clinical burdens and associated health disparities in HIV/AIDS management using big data: potentially inappropriate use and deprescribing of benzodiazepines.
- Author
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Li, Minghui, Lv, Gang, Lee, Tai-Ying, Wu, Jun, and Lu, Kevin
- Subjects
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BENZODIAZEPINES , *INAPPROPRIATE prescribing (Medicine) , *MEDICAL care use , *CROSS-sectional method , *STATISTICAL models , *RESEARCH funding , *INSOMNIA , *LOGISTIC regression analysis , *HOSPITAL care , *OUTPATIENT medical care , *EMERGENCY room visits , *MEDICARE , *HIV infections , *TRANQUILIZING drugs , *DEPRESCRIBING , *DESCRIPTIVE statistics , *PSYCHOLOGY of HIV-positive persons , *ODDS ratio , *PSYCHOLOGY of AIDS patients , *HEALTH equity , *CONFIDENCE intervals , *AIDS , *MEDICAL care costs , *REGRESSION analysis - Abstract
This study aimed to examine factors, healthcare utilization, and medical costs associated with potentially inappropriate use of benzodiazepines in persons living with HIV (PLWH). We used big data from Medicare claims in 2017. Potentially inappropriate use of benzodiazepines was defined as having any benzodiazepine claims in individuals 65+ years or having benzodiazepine claims for more than four weeks in individuals 18–64 years. Logistic regressions, zero-inflated negative binomial regressions, and generalized linear models were used. This study included 1,211 PLWH and 235 (19.41%) had potentially inappropriate use of benzodiazepines. PLWH who were 65+ years (OR: 0.56; 95% CI: 0.33, 0.96), non-Hispanic blacks (OR: 0.29; 95% CI: 0.20, 0.41), or Hispanics (OR: 0.55; 95% CI: 0.35, 0.88) were less likely to use benzodiazepines inappropriately. PLWH who had potentially inappropriate use of benzodiazepines had more inpatient (IRR: 1.46; 95% CI: 1.10, 1.94), outpatient (IRR: 1.14; 95% CI 1.02, 1.28), and emergency room (IRR: 1.32; 95% CI: 1.03, 1.68) visits. Potentially inappropriate use of benzodiazepines was associated with higher total (β: 0.16; 95% CI: 0.07, 0.25), Medicare (β: 0.18; 95% CI: 0.07, 0.28), and out-of-pocket (β: 0.21; 95% CI: 0.05, 0.36) costs. This study provides real-world evidence to support deprescribing benzodiazepines in PLWH. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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