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 - 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
UR - http://www.scopus.com/inward/record.url?scp=85089018835&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089018835&partnerID=8YFLogxK
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 -