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The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality
- Source :
- Journal of General Internal Medicine. 31:492-501
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- For patients receiving long-term opioid therapy (LtOT), the impact of guideline-concordant care on important clinical outcomes—notably mortality—is largely unknown, even among patients with a high comorbidity and mortality burden (e.g., HIV-infected patients). Our objective was to determine the association between receipt of guideline-concordant LtOT and 1-year all-cause mortality. Among HIV-infected and uninfected patients initiating LtOT between 2000 and 2010 through the Department of Veterans Affairs, we used Cox regression with time-updated covariates and propensity-score matched analyses to examine the association between receipt of guideline-concordant care and 1-year all-cause mortality. Of 17,044 patients initiating LtOT between 2000 and 2010, 1048 patients (6%) died during 1 year of follow-up. Patients receiving psychotherapeutic co-interventions (hazard ratio [HR] 0.62; 95% confidence interval [CI] 0.51–0.75; P
- Subjects :
- Adult
Male
medicine.medical_specialty
Databases, Factual
Substance-Related Disorders
HIV Infections
Kaplan-Meier Estimate
Lower risk
Drug Administration Schedule
Benzodiazepines
03 medical and health sciences
0302 clinical medicine
Internal medicine
Internal Medicine
Risk of mortality
Humans
Medicine
030212 general & internal medicine
Mortality
Intensive care medicine
Veterans Affairs
business.industry
Proportional hazards model
Hazard ratio
Capsule Commentary
Middle Aged
medicine.disease
Comorbidity
United States
Confidence interval
Analgesics, Opioid
Substance abuse
Practice Guidelines as Topic
Drug Therapy, Combination
Female
Guideline Adherence
Chronic Pain
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15251497 and 08848734
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Journal of General Internal Medicine
- Accession number :
- edsair.doi.dedup.....0f0eb125308ca8afd77d72e98735211b