Economic and clinical burdens and associated health disparities in HIV/AIDS management using big data: potentially inappropriate use and deprescribing of benzodiazepines.

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  • Author(s): Li M;Li M; Lv G; Lv G; Lee TY; Lee TY; Wu J; Wu J; Lu K; Lu K
  • Source:
    AIDS care [AIDS Care] 2024 May; Vol. 36 (5), pp. 604-611. Date of Electronic Publication: 2020 Nov 19.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 8915313 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0451 (Electronic) Linking ISSN: 09540121 NLM ISO Abbreviation: AIDS Care Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: Abingdon, Oxfordshire, U.K. : Carfax Pub. Co., c1989-
    • Subject Terms:
      Acquired Immunodeficiency Syndrome*/complications ; Deprescriptions* ; HIV Infections*/drug therapy ; HIV Infections*/complications; Aged ; Humans ; United States ; Benzodiazepines/therapeutic use ; Medicare ; Health Inequities ; Retrospective Studies
    • Abstract:
      This study aimed to examine factors, healthcare utilization, and medical costs associated with potentially inappropriate use of benzodiazepines in persons living with HIV (PLWH). We used big data from Medicare claims in 2017. Potentially inappropriate use of benzodiazepines was defined as having any benzodiazepine claims in individuals 65+ years or having benzodiazepine claims for more than four weeks in individuals 18-64 years. Logistic regressions, zero-inflated negative binomial regressions, and generalized linear models were used. This study included 1,211 PLWH and 235 (19.41%) had potentially inappropriate use of benzodiazepines. PLWH who were 65+ years (OR: 0.56; 95% CI: 0.33, 0.96), non-Hispanic blacks (OR: 0.29; 95% CI: 0.20, 0.41), or Hispanics (OR: 0.55; 95% CI: 0.35, 0.88) were less likely to use benzodiazepines inappropriately. PLWH who had potentially inappropriate use of benzodiazepines had more inpatient (IRR: 1.46; 95% CI: 1.10, 1.94), outpatient (IRR: 1.14; 95% CI 1.02, 1.28), and emergency room (IRR: 1.32; 95% CI: 1.03, 1.68) visits. Potentially inappropriate use of benzodiazepines was associated with higher total (β: 0.16; 95% CI: 0.07, 0.25), Medicare (β: 0.18; 95% CI: 0.07, 0.28), and out-of-pocket (β: 0.21; 95% CI: 0.05, 0.36) costs. This study provides real-world evidence to support deprescribing benzodiazepines in PLWH.
    • Contributed Indexing:
      Keywords: HIV; benzodiazepines; cost; deprescribing; potentially inappropriate use; utilization
    • Accession Number:
      12794-10-4 (Benzodiazepines)
    • Publication Date:
      Date Created: 20201120 Date Completed: 20240405 Latest Revision: 20240709
    • Publication Date:
      20240710
    • Accession Number:
      10.1080/09540121.2020.1842320
    • Accession Number:
      33213189