Influence of patient trust in provider and health literacy on receipt of guideline-concordant chronic opioid therapy in HIV care settings.
J Opioid Manag
; 19(5): 385-393, 2023.
Article
em En
| MEDLINE
| ID: mdl-37968972
ABSTRACT
OBJECTIVE:
Persons with HIV (PWH) frequently receive opioids for pain. Health literacy and trust in provider may impact patient-provider communication, and thus receipt of guideline-concordant opioid monitoring. We analyzed baseline data of HIV-positive patients on chronic opioid therapy (COT) in a trial to improve guideline-concordant COT in HIV clinics.DESIGN:
Retrospective cohort study.SETTING:
Two hospital-based safetynet HIV clinics in Boston and Atlanta. PATIENTS ANDPARTICIPANTS:
A cohort of patients who were ≥18 years, HIV-positive, had received ≥ 3 opioid prescriptions from a study site ≥21 days apart within a 6-month period during the prior year and had ≥1 visit at the HIV clinic in the prior 18 months. MAIN OUTCOMEMEASURES:
Adjusted logistic regression models examined whether health literacy and trust in provider (scale scored 11-55, higher indicates more trust) were associated with (1) ≥ 2 urine drug tests (UDTs) and (2) presence of an opioid treatment agreement.RESULTS:
Among 166 PWH, mean trust in provider was 47.4 (SD 6.6); 117 (70 percent) had adequate health literacy. Fifty patients (30 percent) had ≥ 2 UDTs and 20 (12 percent) had a treatment agreement. The adjusted odds ratio (aOR) for a one-point increase in trust in provider was 0.97 for having ≥ 2 UDTs (95 percent CI 0.92-1.02) and 1.03 for opioid treatment agreement (95 percent CI 0.95-1.12). The aOR for adequate health literacy was 0.89 for having ≥ 2 UDTs (95 percent CI 0.42-1.88) and 1.66 for an opioid treatment agreement (95 percent CI 0.52-5.31).CONCLUSIONS:
Health literacy and trust in provider were not associated with chronic opioid therapy quality outcomes.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Letramento em Saúde
/
Dor Crônica
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article