Journal Article

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

Løberg, Else-Marie, Ruths, Sabine, Askildsen, Jan Erik, Fadnes, Lars Thore, Vold, Jørn Henrik, Skurtveit, Svetlana, Islam, Kamrul, Aas, Christer Frode, Lim, Aaron G., Johansson, Kjell Arne

2020

Overview

Background Opioid dependence carries the highest disease burden of all illicit drugs. Opioid agonist therapy (OAT) is an evidence-based medical intervention that reduces morbidity and mortality. There is limited knowledge on the health-related quality of life (HRQoL) of long-term patients in OAT. This study measures HRQoL and self-perceived health of long-term patients on OAT, compares the scores to a Norwegian reference population, and assesses changes in these scores at 1-year follow up. Methods We conducted a nested prospective cohort study among nine OAT outpatient clinics in Norway. 609 OAT patients were included, 245 (40%) followed-up one year later. Data on patient characteristics, HRQoL, and self-perceived health was collected. HRQoL was assessed with the EQ-5D-5L, which measures five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) on a five-point Likert scale (from “no problems” to “extreme problems”). An UK value set was applied to calculate index values (from 0 to 1) for the EQ-5D-5L and compare them to a Norwegian reference population. Self-perceived health was measured with EQ-VAS (from 0 to 100). Results Mean (standard deviation (SD)) EQ-5D-5L index value at baseline was 0.699 (0.250) and EQ-VAS 57 (22) compared to 0.848 (0.200) and 80(19) for the Norwegian reference population. There were large variations in EQ-5D-5L index values, where 43% had > 0.8 and 5% had < 0.2 at baseline. The lowest EQ-5D-5L index values were observed for female patients, age groups older than 40 years and for methadone users. At follow-up, improvements in HRQoL were observed across almost all dimensions and found significant for mobility and pain/discomfort. Mean (SD) overall index value and EQ-VAS at follow up were 0.729 (0.237) and 59 (22) respectively. Conclusion The average HRQoL and self-perceived health of OAT patients is significantly lower than that of the general population, and lower than what has been found among other severe somatic and psychiatric conditions. Around 34% had very good HRQoL, higher than average Norwegian values, and around 5% had extremely poor HRQoL.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age groups / Agonists / Ambulatory care facilities / Analysis / Anxiety / Care and treatment / Clinics / Cohort analysis / Comorbidity / Discomfort / Drug abuse / Drug use / Drugs / Epidemiology / EQ-5D / Evidence-based medicine / Gender / Health / Health aspects / Health Psychology / Health related quality of life / Health status / Hepatitis / Illegal drugs / Indexes / Long term / Measures / Medical research / Medical treatment / Medicine / Medicine & Public Health / Mental disorders / Mental health / Methadone / Mobility / Morbidity / Mortality / Narcotics / Opiate substitution therapy / Opioid abuse / Opioid agonist therapy / Opioid dependence / Opioids / Outpatient clinics / Pain / Patients / Pharmacology/Toxicology / Population / Public Health / Quality of life / Questionnaires / Self care / Self concept / Social Policy / Social Work / Substance abuse treatment / Systematic review / Therapy / Values