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

Abstract

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 selfperceived 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 selfperceived 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.

Prevalence and correlates of suicide attempts in high-risk populations: a cross-sectional study among patients receiving opioid agonist therapy in Norway

“…Additionally, polysubstance use, including substances used alongside OAT opioids, is common among OAT patients, with a prevalence of up to 70 % in this population [24,25]. While OAT may protect against suicide [9,10], polysubstance use is often a substantial contributor to reduced quality of life, homelessness, greater psychological distress, poorer social functioning, and mental disorder comorbidities -such as major depressive symptoms and borderline personality disorder [24,[26][27][28][29][30][31]. This places OAT patients at a high lifetime risk of attempting suicide [22].…”

Non-financial barriers in oral health care: a qualitative study of patients receiving opioid maintenance treatment and professionals’ experiences

“…Substance use has many health-related consequences, including hepatitis [1,2], tuberculosis [3,4], soft tissue infections [5,6], impaired quality of life [7], and anxiety and depression [8][9][10]. Although, oral health problems and oral diseases have been identified as detrimental side effects of substance use, they have received comparatively little attention in the substance use literature [11][12][13][14].…”

Effectiveness and Safety of Low-Threshold Opioid-Agonist Treatment in Hard-To-Reach Populations with Opioid Dependence

“…This is a worrisome trend. Opioid-agonist treatment (OAT) with methadone (Met) and buprenorphine (Bup) is an effective treatment for opioid dependence that improves survival, abstinence from illicit opioids, and quality of life [6][7][8][9][10][11]. However, barriers exist with respect to access to OAT, and the optimal clinical setting is unclear [12].…”