Clinical correlates of health-related quality of life among opioid-dependent patients.

Previous work suggests that opioid users have lower health-related quality of life (HRQOL) than patients with more prevalent chronic illnesses such as hypertension or diabetes. Although comparisons with population norms are informative, studies of the correlates of HRQOL for opioid users are needed to plan clinical services. This article reports on a study that tested a conceptual model of the pathways between physiologic factors and symptoms in relation to HRQOL among 344 opioid users participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) studies about buprenorphine (protocols CTN-0001 and CTN-0002). Physical and mental HRQOL were measured by the Short-Form (SF)-36; withdrawal signs, symptoms, and functioning were also measured with validated instruments. Using structural equation modeling, the authors tested hypotheses that medical history directly predicts withdrawal signs and symptoms, and that medical history, withdrawal signs and symptoms, and functioning predict the physical and mental HRQOL latent variables of the SF-36. The study’s results found most hypothesized relationships to be significant, with good model fit. The model explained 34% of the variance in physical HRQOL. In conclusion, the conceptual framework appears valid for explaining variation in the physical and mental HRQOL of opioid users undergoing medically managed withdrawal. Future work should assess whether opioid dependence treatments that are informed by effects of treatment on HRQOL lead to better outcomes, including increases in patients’ motivation to engage in longer-term rehabilitation efforts.

Related protocols: CTN-0001, CTN-0002