This study will investigate the provision of health care services to a statewide population of HIV-positive Medicaid participants whose service needs are complicated by major psychiatric comorbidities, particularly schizophrenia and schizoaffective disorder. The overall objective is to generate much-needed knowledge about care of these persons so that policies and programs, which have largely been developed on the basis of findings from inpatient samples, can better address their complex needs. The research will use a unique database created by merging multiple New Jersey Medicaid administrative and claims records with HIV/AIDS Registry data, covering the years 1988-1999 for 8,996 individuals, including (according to preliminary classifications) 577 who received at least one inpatient or two outpatient diagnoses with schizophrenia or schizoaffective disorder, with a mean of 55 encounters with schizophrenia diagnoses. We will also examine, as a secondary focus, individuals diagnosed with mood disorders including bipolar disorder and recurrent major depressive disorder, and will explore the association between combinations of psychiatric and substance abuse comorbidities and use of health care services. The study will examine the types and combinations of psychiatric diagnoses reported by health care providers during health care encounters with HIV+ persons on Medicaid; refine claims-based diagnostic classifications; explore the impact of psychiatric conditions on the types and amounts of health care services used over the course of HIV; analyze receipt of mental health services and the type and consistency over time of psychotropic use; and examine the relationship between comorbid major mental disorders, with and without comorbid substance abuse, and patterns of antiretroviral therapy including type of regimen, incidence of use, consistency of use over time, and dropout from treatment. Results of these analyses will provide an important information base for the development of policies and programs to improve the care of this under-studied group within the population living with HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH058984-01A1
Application #
6214026
Study Section
Special Emphasis Panel (ZRG1-AARR-8 (01))
Program Officer
Stoff, David M
Project Start
2000-08-20
Project End
2003-07-31
Budget Start
2000-08-20
Budget End
2001-07-31
Support Year
1
Fiscal Year
2000
Total Cost
$347,100
Indirect Cost
Name
Rutgers University
Department
Type
Organized Research Units
DUNS #
038633251
City
New Brunswick
State
NJ
Country
United States
Zip Code
08901
Finnerty, Molly; Neese-Todd, Sheree; Bilder, Scott et al. (2014) Best Practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices. Psychiatr Serv 65:1297-9
Prince, Jonathan D; Walkup, James; Akincigil, Ayse et al. (2012) Serious mental illness and risk of new HIV/AIDS diagnoses: an analysis of Medicaid beneficiaries in eight states. Psychiatr Serv 63:1032-8
Akincigil, Ayse; Wilson, Ira B; Walkup, James T et al. (2011) Antidepressant treatment and adherence to antiretroviral medications among privately insured persons with HIV/AIDS. AIDS Behav 15:1819-28
Oursler, Krisann K; Goulet, Joseph L; Crystal, Stephen et al. (2011) Association of age and comorbidity with physical function in HIV-infected and uninfected patients: results from the Veterans Aging Cohort Study. AIDS Patient Care STDS 25:13-20
Walkup, James T; Akincigil, Ayse; Chakravarty, Sujoy et al. (2011) Bipolar medication use and adherence to antiretroviral therapy among patients with HIV-AIDS and bipolar disorder. Psychiatr Serv 62:313-6
Walkup, James T; Akincigil, Ayse; Amin, Shahla et al. (2010) Prevalence of diagnosed HIV disease among medicaid beneficiaries with schizophrenia in U.S. metropolitan areas. J Nerv Ment Dis 198:682-6
Crystal, Stephen; Gaboda, Dorothy; Lucas, Judith et al. (2010) Assessing medication exposures and outcomes in the frail elderly: assessing research challenges in nursing home pharmacotherapy. Med Care 48:S23-31
West, Joyce C; Wilk, Joshua E; Rae, Donald S et al. (2010) First-year Medicare Part D prescription drug benefits: medication access and continuity among dual eligible psychiatric patients. J Clin Psychiatry 71:400-10
Walkup, James; Akincigil, Ayse; Bilder, Scott et al. (2009) Psychiatric diagnosis and antiretroviral adherence among adolescent Medicaid beneficiaries diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome. J Nerv Ment Dis 197:354-61
Crothers, Kristina; Goulet, Joseph L; Rodriguez-Barradas, Maria C et al. (2009) Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans. AIDS Educ Prev 21:40-53

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