Health Related Quality of Life in Individuals Transferred from a Needle Exchange Program and Starting Opioid Agonist Treatment

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.

Health-related quality of life of long-term patients receiving opioid agonist therapy: a nested prospective cohort study in Norway

“…Previous research has revealed that HRQoL improves considerably at OAT treatment initiation and the first few months [44]: however, not much research to date has investigated the long-term effect of OAT on patients' HRQoL [7,22,29]. For instance, one study among patients on methadone maintenance treatment found that QoL increased markedly in the beginning of the observation, but decreased after 6 months [45] while other studies only saw improvements in the beginning of observation [27,46].…”

Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder

“…Non-fatal OD is highly prevalent among people who use drugs; experienced by 17–68% and witnessed by 50–96% [ 1 ]. In Sweden, self-reports show that over 70% of people injecting heroin have survived at least one OD [ 39 , 40 ]. These numbers indicate that there may be many OD cases never noted in the patient register.…”

Healthcare Contacts Regarding Circulatory Conditions among Swedish Patients in Opioid Substitution Treatment, with and without On-Site Primary Healthcare

“…Still, the OST patient population in Malmö has a high burden of psychiatric and physical morbidity, comparable to international data. Previous research from Skåne county has shown that 72% of OST patients in Malmö had experienced at least one overdose and 31% had tried to commit suicide [ 46 ].…”