Patterns of medical comorbidities among aging people receiving heroin-assisted treatment: A 10-year single-center repeated cross-sectional study.
Publisher DOI
PubMed ID
42005514
Abstract
Background
This study examined the patterns of medical comorbidities among aging people who use drugs (PWUD) enrolled in a heroin-assisted treatment (HAT) program in Bern, Switzerland, over ten years.Methods
Cross-sectional assessments were conducted at a single HAT center in 2009 (n = 200), 2012 (n = 215), and 2019 (n = 203). A group of long-term participants (n = 102) present at all three time points was identified and compared to other participants over time. Data on demographics; infectious, psychiatric, and medical comorbidities; substance use; and opioid agonist treatment (OAT) were analyzed using descriptive statistics and logistic regression.Results
In 2019, the median age of long-term participants was 52 years, one-third of patients were women. Hepatitis C virus (HCV) RNA positivity declined from 50/102 (49%) in 2009 to 10/102 (9.8%) in 2019, whereas HIV prevalence remained stable at 12% with high treatment uptake. Medical multimorbidity (≥2 medical comorbidities) increased from 8.8% to 37.3% (p < 0.001), with cardiovascular and musculoskeletal diseases being the most common comorbidities. In 2019, non-long-term participants were younger (median 42 years) with lower multimorbidity (16.8% vs. 37.3%, p = 0.008). Ongoing use of non-prescribed drugs (odds ratio (OR) 2.49; 95% confidence interval (CI) 1.17-5.28; p = 0.018) and advancing age (OR 1.08; 95% CI 1.03 - 1.14; p = 0.002) independently predicted multimorbidity in 2019.Conclusions
Over 10 years, prevalence of active HCV infection among PWUD in long-term HAT declined, whereas non-communicable diseases increased. Integrated care models combining OAT with medical services are essential to meet the evolving health needs of this population.
This study examined the patterns of medical comorbidities among aging people who use drugs (PWUD) enrolled in a heroin-assisted treatment (HAT) program in Bern, Switzerland, over ten years.Methods
Cross-sectional assessments were conducted at a single HAT center in 2009 (n = 200), 2012 (n = 215), and 2019 (n = 203). A group of long-term participants (n = 102) present at all three time points was identified and compared to other participants over time. Data on demographics; infectious, psychiatric, and medical comorbidities; substance use; and opioid agonist treatment (OAT) were analyzed using descriptive statistics and logistic regression.Results
In 2019, the median age of long-term participants was 52 years, one-third of patients were women. Hepatitis C virus (HCV) RNA positivity declined from 50/102 (49%) in 2009 to 10/102 (9.8%) in 2019, whereas HIV prevalence remained stable at 12% with high treatment uptake. Medical multimorbidity (≥2 medical comorbidities) increased from 8.8% to 37.3% (p < 0.001), with cardiovascular and musculoskeletal diseases being the most common comorbidities. In 2019, non-long-term participants were younger (median 42 years) with lower multimorbidity (16.8% vs. 37.3%, p = 0.008). Ongoing use of non-prescribed drugs (odds ratio (OR) 2.49; 95% confidence interval (CI) 1.17-5.28; p = 0.018) and advancing age (OR 1.08; 95% CI 1.03 - 1.14; p = 0.002) independently predicted multimorbidity in 2019.Conclusions
Over 10 years, prevalence of active HCV infection among PWUD in long-term HAT declined, whereas non-communicable diseases increased. Integrated care models combining OAT with medical services are essential to meet the evolving health needs of this population.
Date Issued
2026-06
Publication Type
Article
Subject(s)
Subjects
Access to health care
•
Harm reduction
•
Heroin agonist treatment
•
Integrated care
•
Non-communicable diseases
•
Opioid agonist treatment
•
People who use drugs
Language(s)
en
Author(s)
Brandt, Peer W | |
Loebnitz, Sonja |
Additional Credits
Journal
Drug and alcohol dependence reports
Publisher
Elsevier
ISSN
2772-7246
Access(Rights)
Unknown