Abstract
Background Opioid agonist treatment (OAT), for the treatment of heroin dependence, has been reported to improve overall health and lower mortality. Drug use and retention in treatment have often been used as measures of treatment success. More recently, however, researchers have suggested that measurements of quality of life should be an outcome in substance use treatment evaluations. In a recent randomized controlled trial we demonstrated high rates of successful rapid referral from a needle exchange program (NEP) to OAT. The aim of this study was to see whether an improvement in health related quality of life (HRQoL) could be seen at 3-month follow-up after starting OAT and whether it was associated with any baseline characteristics. We also wanted to compare our sample to a sample from the general population with regard to HRQoL. MethodsThis was a 3-month follow-up of 71 patients who started OAT. Measurements of HRQoL with EQ-5D (an instrument developed by the EuroQol group) were made at baseline and at three months. Results Mean EQ-5D VAS (visual analogue scale) for the study sample at baseline was 47.3, which was lower than a Swedish reference population reporting 83.3. Individuals reporting being prescribed a drug for a psychiatric condition had significantly lower EQ-5D index values. Improvement in EQ-5D index score was significantly less for individuals reporting previous overdoses (-0.10, p=0.025). Individuals reporting previous suicide attempts had significantly lower EQ-5D VAS score at baseline. A significant increase of the EQ-5D VAS difference over time was found with a mean difference of 10.94 (p=0.008) for the total sample. Conclusion To our knowledge this is the first time HRQoL as an outcome is reported in a population transferred from a NEP to OAT. Our results indicate that OAT can result in increased HRQoL, even with this type of rapid low-threshold referral.
Highlights
Heroin dependence is a chronic relapsing disorder with high mortality [1,2,3]
In this paper we report measurements of health related quality of life (HRQoL) at baseline and three months into treatment using an instrument developed by the EuroQol group, EQ-5D [49], which has been validated for heroindependent patients [50] and shown to be responsive to decreases in illicit drug use [51]
Mean EQ-5D VAS scores were significantly lower for individuals reporting previous suicide attempts as were mean EQ-5D index scores for individuals taking a psychiatric medication, possibly indicating that more psychological problems were correlated with decreased HRQoL at baseline
Summary
Heroin dependence is a chronic relapsing disorder with high mortality [1,2,3]. Opioid agonist treatment (OAT) with methadone or buprenorphine has been shown to increase social stability, improve somatic and psychiatric health, and lower overall mortality [4,5,6].Traditionally when measuring treatment success we often look at the effect on drug use and retention in treatment. As a complement to “hard” outcomes like retention in treatment and drug use, several researchers suggest that measurement of quality of life (QoL) as an outcome that should be part of any substance use treatment evaluation [10,11,12,13]. Opioid agonist treatment (OAT), for the treatment of heroin dependence, has been reported to improve overall health and lower mortality. The aim of this study was to see whether an improvement in health related quality of life (HRQoL) could be seen at 3-month follow-up after starting OAT and whether it was associated with any baseline characteristics. To our knowledge this is the first time HRQoL as an outcome is reported in a population transferred from a NEP to OAT. Our results indicate that OAT can result in increased HRQoL, even with this type of rapid low-threshold referral
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
