Abstract
Background and aimsThe recent opioid epidemic has prompted renewed interest in opioid use disorder treatment, but there is little evidence regarding health-related quality-of-life (HRQoL) outcomes in treatment programs. Measuring HRQoL represents an opportunity to consider outcomes of opioid use disorder treatment that are more patient-centered and more relevant to overall health than abstinence alone. We conducted a systematic literature review to explore the extent to which the collection of HRQoL by opioid treatment programs is documented in the treatment program literature. Materials and methodsWe searched PubMed, Embase PsycINFO and Web of Science for papers published between 1965 and 2015 that reported HRQoL outcome measures from substance abuse treatment programs. ResultsOf the 3014 unduplicated articles initially identified for screening, 99 articles met criteria for further review. Of those articles, 7 were unavailable in English; therefore 92 articles were reviewed. Of these articles, 44 included any quality-of-life measure, 17 of which included validated HRQoL measures, and 10 supported derivation of quality-adjusted life year utility weights. The most frequently used validated measure was the Addiction Severity Index (ASI). Non-U.S. and more recent studies were more likely to include a measure of HRQoL. ConclusionsHRQoL measures are rarely used as outcomes in opioid treatment programs. The field should incorporate HRQoL measures as standard practice, especially measures that can be used to derive utility weights, such as the SF-12 or EQ-5D. These instruments provide policy makers with evidence on the impact of programs on patients' lives and with data to quantify the value of investing in opioid use disorder treatments.
Highlights
Opioid misuse and opioid use disorders are pervasive public health problems globally
health-related quality-of-life (HRQoL) measures are rarely used as outcomes in opioid treatment programs
The field should incorporate HRQoL measures as standard practice, especially measures that can be used to derive utility weights, such as the SF-12 or EQ-5D. These instruments provide policy makers with evidence on the impact of programs on patients’ lives and with data to quantify the value of investing in opioid use disorder treatments
Summary
Opioid misuse and opioid use disorders are pervasive public health problems globally. Many policy makers view health-related quality-of-life (HRQoL) and quality adjusted life years (QALYs) as important treatment outcomes and as critical inputs for decision-making, for economic evaluations such as cost-effectiveness analyses (CEAs). Despite controversy in the US surrounding the use of QALYs in economic evaluations (Neumann & Weinstein, 2010), the US Preventive Services Task Force (USPSTF) is charged with reviewing “...the scientific evidence related to the effectiveness, appropriateness, and cost-effectiveness of clinical preventive services... The USPSTF lists HRQoL as a relevant health outcome and QALYs as a measure of disease burden (U.S Preventive Services Task Force, 2015). Measuring HRQoL represents an opportunity to consider outcomes of opioid use disorder treatment that are more patient-centered and more relevant to overall health than abstinence alone. We conducted a systematic literature review to explore the extent to which the collection of HRQoL by opioid treatment programs is documented in the treatment program literature
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