Abstract
BackgroundKnowledge of health-related quality of life (HRQOL) of patients receiving opioid substitution treatment (OST) is limited and fragmented. The present study examines the HRQOL of a large national sample of OST patients in Germany and sociodemographic and clinical correlates.MethodsCross-sectional data on the HRQOL of 2176 OST patients was compared with German general population norms. Patients were recruited from 63 OST practices across Germany. To identify correlates of HRQOL, as measured with the SF-12, we performed bi- and multivariate analyses with sociodemographic and clinical variables, including patient- and clinician-reported outcomes on physical and mental health.ResultsPatients’ HRQOL was significantly poorer than in the general population, especially their mental HRQOL. Factors associated with lower physical HRQOL were older age, longer duration of opioid dependence, hepatitis C virus infection, and HIV infection. Benzodiazepine use was associated with lower mental HRQOL, and amphetamine use with higher physical HRQOL, compared to non-use of these substances. For both mental and physical HRQOL, the factor with the strongest positive association was employment and the factors with the strongest negative associations were physical and mental health symptom severity, psychiatric diagnosis, and psychopharmacological medication.ConclusionsCompared to the general population, we found substantially lower HRQOL in OST patients, especially in their mental HRQOL. OST programs can benefit from further improvement, particularly with regard to mental health services, in order to better serve their patients’ needs. Clinicians may consider the use of patient-reported outcome measures to identify patients’ subjective physical and psychological needs. Further research is needed to determine if employment is a cause or consequence of improved HRQOL.Trial registrationClinicalTrials.gov: NCT02395198, retrospectively registered 16/03/2015
Highlights
Knowledge of health-related quality of life (HRQOL) of patients receiving opioid substitution treatment (OST) is limited and fragmented
As our study finds that psychiatric diagnosis and psychopharmacological treatment are associated with both mental and physical HRQOL, one may argue that it is important to address OST patients’ mental health, as it is associated with mental and physical wellbeing
While we found an association of HRQOL with substitution medication, the differences between methadone and buprenorphine are likely confounded with other factors that correlate with buprenorphine prescription, such as age, duration of opioid dependence, and preexisting physical and mental health
Summary
Knowledge of health-related quality of life (HRQOL) of patients receiving opioid substitution treatment (OST) is limited and fragmented. The proportion of people who inject drugs (PWID) who receive OST varies greatly between countries. In Europe, the proportion of patients aged over 40 entering treatment for opioid use increased from 1 in 5 in 2006 to 1 in 3 in 2013 [6, 7]. This reflects an ageing cohort of opioid users who started injecting during the heroin “epidemics” of the 1980s and 1990s and who have shaped and characterized the current European treatment systems [6, 7]. The two decades will pose a challenge, as the large cohorts of opioid users who initiated use in the eighties and nineties are growing old
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
