Health-related quality of life and opioid use disorder pharmacotherapy: A secondary analysis of a clinical trial

Jalali, Ali; Ryan, Danielle; Jeng, Philip J.; McCollister, Kathryn E.; Leff, Jared A.; Lee, Joshua D.; Nunes, Edward V.; Novo, Patricia; Rotrosen, John; Schackman, Bruce R.; Murphy, Sean M.

doi:10.1016/j.drugalcdep.2020.108221

Cited by 13 publications

(6 citation statements)

References 29 publications

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“…Although our study demonstrated a relationship between decrease in QoL and relapse, it is unclear whether relapse preceded or followed a drop in rated QoL. This study supports the body of evidence that shows an association between QoL and relapse [ 42 , 43 , 44 ], however, causation has not been established. One study examining QoL and alcohol use disorder found that improved QoL was associated with abstinence at six months, yet it could not determine if it operated as a predictor [ 42 ].…”

Section: Discussionsupporting

confidence: 71%

“…Researchers examining the role of QoL satisfaction in recovery found overall satisfaction was associated with sustained abstinence, and in fact predicted remission at 1 year [ 43 ]. Another found that MOUD initiation and maintenance is imperative to improved QoL and sustained abstinence [ 44 ]. Intriguingly, a subgroup in this study who reported higher levels of substance use, legal and psychiatric problems, and inadequate family and social support did not show an improvement in quality of life related to MOUD, but instead with social support services.…”

Section: Discussionmentioning

confidence: 99%

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Sociodemographic and Clinical Characteristics Associated with Improvements in Quality of Life for Participants with Opioid Use Disorder

et al. 2022

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Background: The Houston Emergency Opioid Engagement System was established to create an access pathway into long-term recovery for individuals with opioid use disorder. The program determines effectiveness across multiple dimensions, one of which is by measuring the participant’s reported quality of life (QoL) at the beginning of the program and at successive intervals. Methods: A visual analog scale was used to measure the change in QoL among participants after joining the program. We then identified sociodemographic and clinical characteristics associated with changes in QoL. Results: 71% of the participants (n = 494) experienced an increase in their QoL scores, with an average improvement of 15.8 ± 29 points out of a hundred. We identified 10 factors associated with a significant change in QoL. Participants who relapsed during treatment experienced minor increases in QoL, and participants who attended professional counseling experienced the largest increases in QoL compared with those who did not. Conclusions: Insight into significant factors associated with increases in QoL may inform programs on areas of focus. The inclusion of counseling and other services that address factors such as psychological distress were found to increase participants’ QoL and success in recovery.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Sociodemographic and Clinical Characteristics Associated with Improvements in Quality of Life for Participants with Opioid Use Disorder

et al. 2022

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“…The ASI composite score variables were continuous and ranged from 0 to 1. An increase in the ASI composite score indicates increased severity in the associated construct and have been shown to be associated with HRQoL in prior studies [ 38 – 42 ]. The time-varying ASI composite scores were advantageous to the research objective of evaluating determinants of HRQoL surrounding release from incarceration, given the theoretical importance of the information contained therein, and their proximity to the outcomes of interest.…”

Section: Methodsmentioning

confidence: 99%

Determinants of health-related quality of life among individuals with opioid use disorder, recently released from incarceration

Cadet

Jalali

Jeng

et al. 2023

Addict Sci Clin Pract

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Background\Objectives Concomitant with low rates of pharmacotherapy for incarcerated individuals with OUD, there is a high rate of opioid overdose following re-entry into the community. Our research objective was to develop a better understanding of the factors that influence health-related quality-of-life (HRQoL) among this population during the high-risk transition period from incarceration to community. Few studies have assessed health-related quality-of-life (HRQoL) among individuals with OUD who are involved with the criminal-legal system, let alone over the period directly surrounding release from incarceration. Methods Secondary longitudinal analysis of data from a clinical trial where participants were randomized 1:1 to pre-release extended-release naltrexone (XR-NTX) + referral to community XR-NTX, vs. referral only. We conducted individual, multivariable regressions of EQ-5D domains (mobility, pain/discomfort, anxiety/depression; usual activities and self-care were excluded due to insufficient variation in scores), and the overall preference/utility score. HRQoL data were subset to timepoints immediately before release (baseline) and 12 weeks post-release; treatment groups were collapsed across condition. Multiple imputation by chained equations was conducted to handle missing 3-month data in the dependent variables and covariates, ad hoc. Results Greater severity in the psychiatric composite score was associated with substantially lower HRQoL, across all measures, following release from incarceration. Greater severity in the medical composite score was associated with lower pain/discomfort-related HRQoL. Conclusions Our findings highlight the importance of ensuring individuals with OUD are linked not only to MOUD, but also treatment for their comorbid conditions upon release from incarceration.

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“…Quality of life as a classification of OUD care quality measurement is imperative because it both predicts treatment retention and is a clinical endpoint itself. [69][70][71][72] While quality of life measurement for OUD remains underdeveloped and is rarely incorporated into practice, it has nevertheless garnered attention over the last decade as part of healthcarewide trends toward value-based payment. OUD's immense societal cost is predominantly attributable to decreased quality of life.…”

Section: Quality Of Lifementioning

confidence: 99%

Patient-Centered Quality Measurement for Opioid Use Disorder: Development of a Taxonomy to Address Gaps in Research and Practice

et al. 2022

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Background: Evidence-based treatment is provided infrequently and inconsistently to patients with opioid use disorder (OUD). Treatment guidelines call for high-quality, patient-centered care that meets individual preferences and needs, but it is unclear whether current quality measures address individualized aspects of care and whether measures of patient-centered OUD care are supported by evidence. Methods: We conducted an environmental scan of OUD care quality to (1) evaluate patient-centeredness in current OUD quality measures endorsed by national agencies and in national OUD treatment guidelines; and (2) review literature evidence for patient-centered care in OUD diagnosis and management, including gaps in current guidelines, performance data, and quality measures. We then synthesized these findings to develop a new quality measurement taxonomy that incorporates patient-centered aspects of care and identifies priority areas for future research and quality measure development. Results: Across 31 endorsed OUD quality measures, only two measures of patient experience incorporated patient preferences and needs, while national guidelines emphasized providing patient-centered care. Among 689 articles reviewed, evidence varied for practices of patient-centered care. Many practices were supported by guidelines and substantial evidence, while others lacked evidence despite guideline support. Our synthesis of findings resulted in EQuIITable Care, a taxonomy comprised of six classifications: (1) patient Experience and engagement, (2) Quality of life; (3) Identification of patient risks; (4) Interventions to mitigate patient risks; (5) Treatment; and (6) Care coordination and navigation. Conclusions: Current quality measurement for OUD lacks patient-centeredness. EQuIITable Care for OUD provides a roadmap to develop measures of patient-centered care for OUD.

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Health-related quality of life and opioid use disorder pharmacotherapy: A secondary analysis of a clinical trial

Cited by 13 publications

References 29 publications

Sociodemographic and Clinical Characteristics Associated with Improvements in Quality of Life for Participants with Opioid Use Disorder

Sociodemographic and Clinical Characteristics Associated with Improvements in Quality of Life for Participants with Opioid Use Disorder

Determinants of health-related quality of life among individuals with opioid use disorder, recently released from incarceration

Patient-Centered Quality Measurement for Opioid Use Disorder: Development of a Taxonomy to Address Gaps in Research and Practice

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