Association between opioid use and health care utilization as measured by emergency room visits and hospitalizations among persons living with HIV.
BACKGROUND
Epidemiologic studies in the non-human immunodeficiency virus (HIV) positive population have shown greater health care utilization among persons with chronic non-cancer pain on opioid therapy. However, we are not aware of any similar data in the HIV positive population.


METHODS
We evaluated health care utilization, as measured by emergency room (ER) visits and hospitalizations, among persons with HIV and chronic pain seen at an academic medical center, during the calendar year 2005. We compared these outcomes between patients on chronic opioid therapy with those not on opioids.


RESULTS
In univariate models chronic opioid therapy was associated with both ER visits and hospitalization: ER visits odds ratio (OR)=2.18 (95% confidence interval [CI], 1.30-3.66), hospitalization OR=1.90 (95% CI, 1.03-3.51). After multivariate analyses only nonsignificant trends remain: ER visits OR=1.71 (95% CI, 0.95-3.08); hospitalization OR=1.28 (95% CI, 0.66-2.49).


CONCLUSIONS
In our study HIV positive individuals with chronic pain were more likely to be seen in the ER and be hospitalized if they were on opioids. However, after controlling for other variables, the association with opioids no longer remained significant.
Divisions of *General Internal Medicine †Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, CO ‡Department of Epidemiology, Children's Hospital Colorado, Aurora.
John
J
Koeppe
Karen
K
Lyda
Carl
C
Armon
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016208:Databases, Factual / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000188:drug therapy*
D000701:Analgesics, Opioid