Patient’s early satisfaction with care: a predictor of health-related quality of life change among outpatients with substance dependence

Abstract

Background: Although research on health-related quality of life (HRQoL) has increased in the addiction field, few studies have focused on the determinants of HRQoL changes. This study aimed to describe dependent patients' HRQoL changes at a 3-month follow-up and to assess whether satisfaction with care can predict those changes among outpatients starting care for alcohol or opioid dependence. Methods: HRQoL was measured with the SF-12 at baseline and 3 months later in a prospective cohort of dependent outpatients. Satisfaction was assessed with the EQS-C early after inclusion. Data on sociodemographics, clinical characteristics and patients' levels of anxiety and depression were also collected. A multivariable analysis was performed to identify factors associated with HRQoL changes in both the physical and mental component summary scores (PCS and MCS, respectively). Results: Of the 172 patients included at baseline, a total of 136 patients assessed their satisfaction with care. The mean PCS and MCS scores were initially low, and HRQoL improvement was significant after 3 months for both the PCS and MCS. Never having been married (β = 5.5; p = 0.001) and a lower baseline PCS score (β = − 0.6; p < 0.0001) were associated with significant PCS improvement, whereas being legally compelled to undergo drug treatment (β = − 5.9; p = 0.02) was associated with less PCS change. Higher early satisfaction with care (β = 0.1; p = 0.02) and a lower baseline MCS score (β = − 0.7; p < 0.0001) were associated with significant MCS improvement. Conclusion: The study supported the hypothesis that greater satisfaction with care may predict HRQoL improvement among dependent outpatients. Further studies are needed to understand the factors that affect patients' early satisfaction to identify areas of improvement and thus improve HRQoL.

Health-related quality of life in outpatients with substance use disorder: evolution over time and associated factors

“…A physical health component summary (PCS) and a mental health component summary (MCS) were calculated from all 12 items. The properties of the SF-12 were evaluated in the same population in a previous study [4]. All scores are transformed into standardized 0-100 scores.…”

“…Each subscale has three ranges using cutoff scores indicating the severity of distress levels: 0-7 (noncases), 8-10 (mild severity), and 11-21 (moderate or severe severity) [38]. The HADS properties were evaluated in the same population in a previous study [4].…”

“…Substance use disorder (SUD) produces unstable life patterns, as it impacts many areas of an individual's global functioning across a broad range of life domains [1,2]. SUDs adversely affect the quality of life of patients, including their working life, interpersonal relationships, social activities, and physical and mental states [3,4]. Based on the Global Burden of Disease (GBD) study, substance abuse was responsible for 20 million disability-adjusted life years at the global level in 2010 [5].…”

“…Longitudinal studies help to examine HRQoL as well as positive and significant changes during care in both men and women [14][15][16]. Follow-up assessments from previous studies showed that the improvement in HRQoL among outpatients with substance use disorders receiving care was rapid in the first 3 months [4,[16][17][18] and slower over the later period of 3-8 months when HRQoL assessments were repeated [18,19]. A previous work even reported that the best HRQoL was achieved at 6 months of care during a 1-year observation period [20].…”

“…The results from longitudinal studies using the SF-36 or the SF-12 with substance use clinical populations reported more improvement over time, especially in patients' mental states [17,21]. Divergent findings were reported in patients' physical states; some studies showed small but significant improvements in physical component summary scores [4,22], whereas others did not [21].…”