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The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality.


ABSTRACT:

Purpose

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.

Methods

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.

Results

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?ConclusionsProviders should use caution in initiating LtOT in conjunction with benzodiazepines and untreated SUDs. Patients receiving LtOT may benefit from multi-modal treatment that addresses chronic pain and its associated comorbidities across multiple disciplines.

SUBMITTER: Gaither JR 

PROVIDER: S-EPMC4835362 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature

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The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality.

Gaither Julie R JR   Goulet Joseph L JL   Becker William C WC   Crystal Stephen S   Edelman E Jennifer EJ   Gordon Kirsha K   Kerns Robert D RD   Rimland David D   Skanderson Melissa M   Justice Amy C AC   Fiellin David A DA  

Journal of general internal medicine 20160501 5


<h4>Purpose</h4>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.<h4>Methods</h4>Among HIV-infected and uninfected patients initiating LtOT between 2000 and 2010 t  ...[more]

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