TY - JOUR
T1 - Health-related quality of life and opioid use disorder pharmacotherapy
T2 - A secondary analysis of a clinical trial
AU - Jalali, Ali
AU - Ryan, Danielle A.
AU - Jeng, Philip J.
AU - McCollister, Kathryn E.
AU - Leff, Jared A.
AU - Lee, Joshua D.
AU - Nunes, Edward V.
AU - Novo, Patricia
AU - Rotrosen, John
AU - Schackman, Bruce R.
AU - Murphy, Sean M.
N1 - Funding Information:
This research was supported in part by the National Institute on Drug Abuse ( P30DA040500 , R01DA035808 , R01DA046721 ). U10DA013046, UG1/U10DA013035, UG1/U10DA013034, U10DA013045, UG1/U10DA013720, UG1/U10DA013732, UG1/U10DA013714, UG1/U10DA015831, U10DA015833, HHSN271201200017C and HHSN271201500065C from the NIDA National Drug Abuse Treatment Clinical Trials Network ; and K24DA022412 (to Dr. Nunes). The authors gratefully acknowledge the NIDA CTN Publications Committee members for their feedback on a previous version of this manuscript. An earlier version of this work was accepted for poster presentation at the 2020 International Society for Pharmacoeconomics and Outcomes Research (cancelled) in Orlando, FL on May 16 - 20, 2020. The content of this article is solely the responsibility of the authors and does not necessarily represent the official view of the funding agency or the US government.
Funding Information:
This research was supported in part by the National Institute on Drug Abuse (P30DA040500, R01DA035808, R01DA046721). U10DA013046, UG1/U10DA013035, UG1/U10DA013034, U10DA013045, UG1/U10DA013720, UG1/U10DA013732, UG1/U10DA013714, UG1/U10DA015831, U10DA015833, HHSN271201200017C and HHSN271201500065C from the NIDA National Drug Abuse Treatment Clinical Trials Network; and K24DA022412 (to Dr. Nunes). The authors gratefully acknowledge the NIDA CTN Publications Committee members for their feedback on a previous version of this manuscript. An earlier version of this work was accepted for poster presentation at the 2020 International Society for Pharmacoeconomics and Outcomes Research (cancelled) in Orlando, FL on May 16 - 20, 2020. The content of this article is solely the responsibility of the authors and does not necessarily represent the official view of the funding agency or the US government.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Objective: To examine the health-related quality-of-life (HRQoL) of persons with opioid use disorder (OUD) seeking treatment in an inpatient detoxification or short-term residential setting; continuing treatment as outpatients. Methods: We conducted a secondary analysis of data from a clinical trial (N = 508) where participants were randomized to extended-release naltrexone or buprenorphine-naloxone for the prevention of opioid relapse. We used a generalized structural equation regression mixture model to identify associations of HRQoL (EQ-5D) trajectories, including latent characteristics, over the 24-week trial and 36-week follow-up period, among participants who reported HRQoL beyond baseline. This novel framework accounted for baseline and time-varying characteristics, while simultaneously identifying latent classes. Results: We identified two subpopulations: HRQoL “pharmacotherapy responsive” (82.3 %) and HRQoL “characteristic sensitive” (17.7 %). The pharmacotherapy responsive subpopulation was characterized by a shortterm HRQoL improvement and then stable HRQoL over time, and by a positive association between HRQoL and receiving pharmacotherapy in the past 30 days. The characteristic sensitive subpopulation was characterized by an initial improvement in HRQoL with a gradual decline over time, and no significant HRQoL response to pharmacotherapy. HRQoL changes over time in this subpopulation were more influenced by baseline demographic, socioeconomic, and psychosocial characteristics. Conclusion: Our findings suggest that while HRQoL may be improved and sustained through targeted efforts to promote use of pharmacotherapy for many persons with OUD, an identifiable subpopulation may require additional services that address socioeconomic and psychosocial issues to achieve HRQoL benefits. Our analysis provides insight for improving individualized care for persons with opioid use disorder seeking treatment.
AB - Objective: To examine the health-related quality-of-life (HRQoL) of persons with opioid use disorder (OUD) seeking treatment in an inpatient detoxification or short-term residential setting; continuing treatment as outpatients. Methods: We conducted a secondary analysis of data from a clinical trial (N = 508) where participants were randomized to extended-release naltrexone or buprenorphine-naloxone for the prevention of opioid relapse. We used a generalized structural equation regression mixture model to identify associations of HRQoL (EQ-5D) trajectories, including latent characteristics, over the 24-week trial and 36-week follow-up period, among participants who reported HRQoL beyond baseline. This novel framework accounted for baseline and time-varying characteristics, while simultaneously identifying latent classes. Results: We identified two subpopulations: HRQoL “pharmacotherapy responsive” (82.3 %) and HRQoL “characteristic sensitive” (17.7 %). The pharmacotherapy responsive subpopulation was characterized by a shortterm HRQoL improvement and then stable HRQoL over time, and by a positive association between HRQoL and receiving pharmacotherapy in the past 30 days. The characteristic sensitive subpopulation was characterized by an initial improvement in HRQoL with a gradual decline over time, and no significant HRQoL response to pharmacotherapy. HRQoL changes over time in this subpopulation were more influenced by baseline demographic, socioeconomic, and psychosocial characteristics. Conclusion: Our findings suggest that while HRQoL may be improved and sustained through targeted efforts to promote use of pharmacotherapy for many persons with OUD, an identifiable subpopulation may require additional services that address socioeconomic and psychosocial issues to achieve HRQoL benefits. Our analysis provides insight for improving individualized care for persons with opioid use disorder seeking treatment.
KW - Health-related quality-of-life
KW - Latent class analysis
KW - Medications for opioid use disorder
KW - Opioid use disorder
KW - Regression mixture modeling
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U2 - 10.1016/j.drugalcdep.2020.108221
DO - 10.1016/j.drugalcdep.2020.108221
M3 - Article
C2 - 32777692
AN - SCOPUS:85089018835
SN - 0376-8716
VL - 215
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
M1 - 108221
ER -