PMID- 25550126
OWN - NLM
STAT- MEDLINE
DCOM- 20160122
LR  - 20181202
IS  - 1468-2869 (Electronic)
IS  - 1099-3460 (Print)
IS  - 1099-3460 (Linking)
VI  - 92
IP  - 1
DP  - 2015 Feb
TI  - Buprenorphine maintenance treatment retention improves nationally recommended 
      preventive primary care screenings when integrated into urban federally qualified 
      health centers.
PG  - 193-213
LID - 10.1007/s11524-014-9924-1 [doi]
AB  - Buprenorphine maintenance therapy (BMT) expands treatment access for opioid 
      dependence and can be integrated into primary health-care settings. Treating 
      opioid dependence, however, should ideally improve other aspects of overall 
      health, including preventive services. Therefore, we examined how BMT affects 
      preventive health-care outcomes, specifically nine nationally recommended primary 
      care quality health-care indicators (QHIs), within federally qualified health 
      centers (FQHCs) from an observational cohort study of 266 opioid-dependent 
      patients initiating BMT between 07/01/07 and 11/30/08 within Connecticut's 
      largest FQHC network. Nine nationally recommended preventive QHIs were collected 
      longitudinally from electronic health records, including screening for chronic 
      infections, metabolic conditions, and cancer. A composite QHI score (QHI-S), 
      based on the percentage of eligible QHIs achieved, was categorized as QHI-S >/=80% 
      (recommended) and >/=90% (optimal). The proportion of subjects achieving a 
      composite QHI-S >/=80 and >/=90 % was 57.1 and 28.6%, respectively. Screening was 
      highest for hypertension (91.0%), hepatitis C (80.1%), hepatitis B (76.3%), human 
      immunodeficiency virus (71.4%), and hyperlipidemia (72.9%) and lower for syphilis 
      (49.3%) and cervical (58.5%), breast (44.4%), and colorectal (48.7%) cancer. 
      Achieving QHI-S >/=80% was positively and independently associated with >/=3-month 
      BMT retention (adjusted odds ratio (AOR) = 2.19; 95% confidence interval 
      (CI) = 1.18-4.04) and BMT prescription by primary care providers (PCPs) rather 
      than addiction psychiatric specialists (AOR = 3.38; 95% CI = 1.78-6.37), and 
      negatively with being female (AOR = 0.30; 95% CI = 0.16-0.55). Within primary 
      health-care settings, achieving greater nationally recommended health-care 
      screenings or QHIs was associated with being able to successfully retain patients 
      on buprenorphine longer (3 months or more) and when buprenorphine was prescribed 
      simultaneously by PCPs rather than psychiatric specialists. Decreased preventive 
      screening for opioid-dependent women, however, may require gender-based 
      strategies for achieving health-care parity. When patients can be retained, 
      integrating BMT into urban FQHCs is associated with improved health outcomes 
      including increased multiple preventive health-care screenings.
FAU - Haddad, Marwan S
AU  - Haddad MS
AD  - Community Health Center, Inc., 635 Main Street, Middletown, CT, 06457, USA, 
      haddadm@chc1.com.
FAU - Zelenev, Alexei
AU  - Zelenev A
FAU - Altice, Frederick L
AU  - Altice FL
LA  - eng
GR  - K01 DA037826/DA/NIDA NIH HHS/United States
GR  - K24 DA017072/DA/NIDA NIH HHS/United States
GR  - P30 MH062294/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Urban Health
JT  - Journal of urban health : bulletin of the New York Academy of Medicine
JID - 9809909
RN  - 40D3SCR4GZ (Buprenorphine)
SB  - IM
MH  - Adult
MH  - Buprenorphine/*therapeutic use
MH  - Cohort Studies
MH  - Connecticut
MH  - Female
MH  - Humans
MH  - Maintenance Chemotherapy/*methods/statistics & numerical data
MH  - Male
MH  - Mass Screening/*statistics & numerical data
MH  - Middle Aged
MH  - Opioid-Related Disorders/*drug therapy
MH  - Primary Health Care/*methods/statistics & numerical data
MH  - Substance Abuse Treatment Centers/*statistics & numerical data
MH  - Urban Population/*statistics & numerical data
MH  - Young Adult
PMC - PMC4338126
EDAT- 2015/01/01 06:00
MHDA- 2016/01/23 06:00
PMCR- 2016/02/01
CRDT- 2015/01/01 06:00
PHST- 2015/01/01 06:00 [entrez]
PHST- 2015/01/01 06:00 [pubmed]
PHST- 2016/01/23 06:00 [medline]
PHST- 2016/02/01 00:00 [pmc-release]
AID - 9924 [pii]
AID - 10.1007/s11524-014-9924-1 [doi]
PST - ppublish
SO  - J Urban Health. 2015 Feb;92(1):193-213. doi: 10.1007/s11524-014-9924-1.