Evidence map›Paper›PMID 31856946›Full record

ArticleJournal of substance abuse treatment2020

Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.

Benjamin J Oldfield, Kathleen A McGinnis, E Jennifer Edelman, Emily C Williams, Adam J Gordon, Kathleen Akgün, Stephen Crystal, Lynn E Fiellin, Julie R Gaither, Joseph L Goulet and 6 more

Abstract read
In one paragraph

Article in Journal of substance abuse treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Benjamin J OldfieldNational Clinician Scholars Program, Yale School of Medicine, New Haven, CT, United States of America; Department of Medicine, Yale School of Medicine, New Haven, CT, United States of America; Department of Pediatrics, Yale School of Medicine, New Haven, CT, United States of America. Electronic address: benjamin.oldfield@yale.edu.
Kathleen A McGinnisDepartment of Medicine, VA Connecticut Healthcare System, West Haven, CT, United States of America.
E Jennifer EdelmanDepartment of Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Emily C WilliamsSchool of Public Health, University of Washington, Seattle, WA, United States of America; Health Services Research and Development, VA Puget Sound Healthcare Services, Seattle, WA, United States of America.
Adam J GordonDepartment of Medicine, University of Utah, Salt Lake City, UT, United States of America; Department of Medicine, Salt Lake City VA Health Care System, Salt Lake City, UT, United States of America.
Kathleen AkgünDepartment of Medicine, Yale School of Medicine, New Haven, CT, United States of America; Department of Medicine, VA Connecticut Healthcare System, West Haven, CT, United States of America.
Stephen CrystalSchool of Social Work, Rutgers University, New Brunswick, NJ, United States of America.
Lynn E FiellinDepartment of Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Julie R GaitherDepartment of Pediatrics, Yale School of Medicine, New Haven, CT, United States of America.
Joseph L GouletDepartment of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America.
P Todd KorthuisDepartment of Medicine, Oregon Health Sciences University, Portland, OR, United States of America.
Brandon D L MarshallSchool of Public Health, Brown University, Providence, RI, United States of America.
Amy C JusticeDepartment of Medicine, Yale School of Medicine, New Haven, CT, United States of America; Department of Medicine, VA Connecticut Healthcare System, West Haven, CT, United States of America.
Kendall BryantNational Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America.
David A FiellinDepartment of Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Kevin L KraemerDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Alcohol Associated Outcomes Among HIV+/- Aging VeteransU10AA013566 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2006 to 2010
$12.7M
Alcohol and Multisubstance Use in the Veterans Aging Cohort StudyU01AA020790 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$7.7M
Sex Disparities in Overall Response to ART Among HIV Infected IndividualsU24AA020794 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$5.5M
Integrated Stepped Care for Unhealthy Alcohol Use in HIVU01AA020795 · NIAAA · YALE UNIVERSITY · PI FIELLIN, DAVID · 2011 to 2020
$5.2M
Center for Education and Research on Mental Health TherapeuticsU19HS021112 · AHRQ · RUTGERS, THE STATE UNIV OF N.J. · PI CRYSTAL, STEPHEN · 2011 to 2015
$3.9M
3/3 COMpAAAS Tripartite: ART-CC, KP, and VAU01AA026224 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2017 to 2021
$2.9M
Comparative Effectiveness of Alcohol and Drug Treatment in HIV-Infected VeteransR01AA022886 · NIAAA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KRAEMER, KEVIN L · 2014 to 2018
$2.4M
AHRQ HHS U19 HS021112NCATS NIH HHS UL1 TR001863NIAAA NIH HHS R01 AA022886NIAAA NIH HHS U01 AA020790NIAAA NIH HHS U01 AA020795NIAAA NIH HHS U01 AA026224NIAAA NIH HHS U10 AA013566NIAAA NIH HHS U24 AA020794
6 · The paper itself

Abstract

introductionInfrequent use of and poor retention on evidence-based medications for alcohol use disorder (MAUD) represent a treatment gap, particularly among people living with HIV (PLWH). We examined predictors of MAUD initiation and retention across HIV status.

methodsFrom Veterans Aging Cohort Study (VACS) data, we identified new alcohol use disorder (AUD) diagnoses from 1998 to 2015 among 163,339 individuals (50,826 PLWH and 112,573 uninfected, matched by age, sex, and facility). MAUD initiation was defined as a prescription fill for naltrexone, acamprosate or disulfiram within 30 days of a new diagnosis. Among those who initiated, retention was defined as filling medication for ≥80% of days over the following six months. We used multivariable logistic regression to assess patient- and facility-level predictors of AUD medication initiation across HIV status.

resultsAmong 10,603 PLWH and 24,424 uninfected individuals with at least one AUD episode, 359 (1.0%) initiated MAUD and 49 (0.14%) were retained. The prevalence of initiation was lower among PLWH than those without HIV (adjusted odds ratio [AOR] 0.66, 95% confidence interval [CI] 0.51-0.85). Older age (for PLWH: AOR 0.78, 95% CI 0.61-0.99; for uninfected: AOR 0.70, 95% CI 0.61-0.80) and black race (for PLWH: AOR 0.63, 95% CI 0.0.49-0.1.00; for uninfected: AOR 0.63, 95% CI 0.48-0.83), were associated with decreased odds of initiation for both groups. The low frequency of retention precluded multivariable analyses for retention.

conclusionsFor PLWH and uninfected individuals, targeted implementation strategies to expand MAUD are needed, particularly for specific subpopulations (e.g. black PLWH).

Indexed as

AlcoholismAcamprosateAlcohol DeterrentsCohort StudiesFemaleHIV InfectionsHumansMaleMiddle AgedNaltrexonePrevalenceVeteransAcamprosateAlcohol DeterrentsNaltrexone

Identifiers

PMID31856946
PMCPMC6982467

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.