@article {4231,
	title = {Guideline-Concordant Management of Opioid Therapy among HIV-Infected and Uninfected Veterans.},
	journal = {The journal of pain : official journal of the American Pain Society},
	year = {2014},
	month = {2014 Aug 21},
	abstract = {Whether patients receive guideline-concordant opioid therapy (OT) is largely unknown and may vary based on provider and patient characteristics. We assessed the extent to which HIV-infected and uninfected patients initiating long-term (>=90-days) OT received care concordant with American Pain Society/American Academy of Pain Medicine and Department of Veterans Affairs/Department of Defense guidelines by measuring receipt of 17 indicators during the first 6 months of OT. Of 20,753 patients, HIV-infected patients (n= 6,604) were more likely than uninfected patients to receive a primary care provider (PCP) visit within 1-month (52.0\% vs. 30.9\%) and 6-months (90.7\% vs. 73.7\%) and urine drug tests (UDTs) within 1-month (14.8\% vs. 11.5\%) and 6-months (19.5\% vs. 15.4\%; all p < .001). HIV-infected patients were also more likely to receive OT concurrent with sedatives (24.6\% vs. 19.6\%) and an untreated substance use disorder (SUD; 21.6\% vs. 17.2\%). Among both patient groups, only modest changes in guideline-concordance were observed over time: UDTs and OT concurrent with untreated SUDs increased, while sedative co-prescriptions decreased (all p for trend < .001). Over a 10-year period, on average, patients received no more than 40\% of recommended indicators. OT guideline-concordant care is rare in primary care, varies by patient/provider characteristics, and has undergone few changes over time.},
	issn = {1528-8447},
	doi = {10.1016/j.jpain.2014.08.004},
	author = {Gaither, Julie R and Goulet, Joseph L and Becker, William C and Crystal, Stephen and Edelman, E Jennifer and Gordon, Kirsha and Kerns, Robert D and Rimland, David and Skanderson, Melissa and Weisberg, Daniel and Justice, Amy C and Fiellin, David A}
}
