title: Hypertension, chronic obstructive pulmonary disease, diabetes and depression among older methadone maintenance patients in British Columbia.
abstract: OBJECTIVE
  Risk factors in older methadone maintenance treatment (MMT) patients may put them at a greater risk of acquiring chronic diseases; however, this group might experience barriers to treatment resulting in reduced recommended prescriptions. The research objective for this study was to assess whether MMT patients were significantly different from a matched control group in terms of medications dispensed for hypertension, chronic obstructive pulmonary disease (COPD), diabetes and depression.
  
  
  METHODS
  The research design was a case-control study, where prescription claims data from the British Columbia database were used. MMT patients 50 years of age and older were randomly selected, and control subjects were individually matched in terms of age, sex, social assistance coverage and geographic jurisdiction.
  
  
  RESULTS
  Each group consisted of 199 participants. Odds ratios (OR) were calculated to compare the odds of MMT patients to non-MMT patients on a first-line medication for each chronic disease under investigation. The MMT group was significantly more likely to receive medications for COPD (OR = 32.68, P < 0.001) and depression (OR = 4.07, P < 0.001), and no significant differences for hypertension (OR = 0.86) or diabetes (OR = 0.74).
  
  
  CONCLUSIONS
  Higher rates of COPD among MMT clients is likely explained by elevated smoking, and higher rates of depression may be explained by multiple disadvantages associated with substance use. Although the groups were similar for diabetes prescriptions, the MMT group likely experienced barriers to receiving treatment since prior research suggests their rates should be elevated due to methadone use.
authors.affiliation: School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Maruyama
authors.forename: Scott
authors.initials: S
authors.lastname: Macdonald
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Borycki
authors.forename: Jinhui
authors.initials: J
authors.lastname: Zhao
mesh_terms: D001955:British Columbia; D016022:Case-Control Studies; D002908:Chronic Disease; D003863:Depression / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000188:drug therapy; D004363:Drug Utilization; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy
chemical_list: D008691:Methadone
keywords: aged; case-control study; chronic disease; methadone maintenance treatment; opioid dependence