{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:16:52Z","timestamp":1787008612963,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA037768"],"award-info":[{"award-number":["R01DA037768"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008374","name":"Emory Center for AIDS Research","doi-asserted-by":"crossref","award":["P30 AI050409"],"award-info":[{"award-number":["P30 AI050409"]}],"id":[{"id":"10.13039\/100008374","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Boston\/Providence Center for AIDS Research","award":["P30 AI042853"],"award-info":[{"award-number":["P30 AI042853"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain is prevalent among people living with human immunodeficiency virus (PLWH); managing pain with chronic opioid therapy (COT) is common. Human immunodeficiency virus (HIV) providers often diverge from prescribing guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 2-arm, unblinded, cluster-randomized clinical trial assessed whether the Targeting Effective Analgesia in Clinics for HIV (TEACH) intervention improves guideline-concordant care compared to usual care for PLWH on COT. The trial was implemented from 2015 to 2018 with 12-month follow-up at safety-net hospital\u2013based HIV clinics in Boston and Atlanta. We enrolled 41 providers and their 187 patients on COT. Prescribers were randomized 1:1 to either a 12-month intervention consisting of a nurse care manager with an interactive electronic registry, opioid education, academic detailing, and access to addiction specialists or a control condition consisting of usual care. Two primary outcomes were assessed through electronic medical records: \u22652 urine drug tests and any early COT refills by 12 months. Other outcomes included possible adverse consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 12 months, the TEACH intervention arm had higher odds of \u22652 urine drug tests than the usual care arm (71% vs 20%; adjusted odds ratio [AOR], 13.38 [95% confidence interval {CI}, 5.85\u201330.60]; P &amp;lt; .0001). We did not detect a statistically significant difference in early refills (22% vs 30%; AOR, 0.55 [95% CI, .26\u20131.15]; P = .11), pain severity (6.30 vs 5.76; adjusted mean difference, 0.10 [95% CI, \u22121.56 to 1.75]; P = .91), or HIV viral load suppression (86.9% vs 82.1%; AOR, 1.21 [95% CI, .47\u20133.09]; P = .69).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TEACH is a promising intervention to improve adherence to COT guidelines without evident adverse consequences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1025","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T15:12:37Z","timestamp":1594912357000},"page":"e2052-e2058","source":"Crossref","is-referenced-by-count":18,"title":["Improving the Delivery of Chronic Opioid Therapy Among People Living With Human Immunodeficiency Virus: A Cluster Randomized Clinical Trial"],"prefix":"10.1093","volume":"73","author":[{"given":"Jeffrey H","family":"Samet","sequence":"first","affiliation":[{"name":"Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA"},{"name":"Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA"},{"name":"Clinical Addiction Research and Education Unit, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith I","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Y","family":"Walley","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA"},{"name":"Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA"},{"name":"Clinical Addiction Research and Education Unit, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A","family":"Colasanti","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"},{"name":"Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah S","family":"Forman","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Root","sequence":"additional","affiliation":[{"name":"Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W","family":"Shanahan","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA"},{"name":"Clinical Addiction Research and Education Unit, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret 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