Ali Jalali1, Danielle A Ryan2, Philip J Jeng2, Kathryn E McCollister3, Jared A Leff2, Joshua D Lee4, Edward V Nunes5, Patricia Novo4, John Rotrosen4, Bruce R Schackman2, Sean M Murphy2. 1. Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA. Electronic address: alj4004@med.cornell.edu. 2. Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA. 3. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA. 4. New York University Grossman School of Medicine, New York, NY, USA. 5. New York State Psychiatric Institute, Columbia University Medical Center, New York, NY USA.
Abstract
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.
RCT Entities:
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.
Authors: Bohdan Nosyk; Daphne P Guh; Huiying Sun; Eugenia Oviedo-Joekes; Suzanne Brissette; David C Marsh; Martin T Schechter; Aslam H Anis Journal: Drug Alcohol Depend Date: 2011-05-04 Impact factor: 4.492
Authors: Lesia M Ruglass; Jennifer Scodes; Martina Pavlicova; Aimee N C Campbell; Skye Fitzpatrick; Celestina Barbosa-Leiker; Kathleen Burlew; Shelly F Greenfield; John Rotrosen; Edward V Nunes Journal: Drug Alcohol Depend Date: 2019-10-21 Impact factor: 4.492
Authors: Sean M Murphy; Kathryn E McCollister; Jared A Leff; Xuan Yang; Philip J Jeng; Joshua D Lee; Edward V Nunes; Patricia Novo; John Rotrosen; Bruce R Schackman Journal: Ann Intern Med Date: 2018-12-18 Impact factor: 25.391
Authors: Briony Larance; Natacha Carragher; Richard P Mattick; Nicholas Lintzeris; Robert Ali; Louisa Degenhardt Journal: Drug Alcohol Depend Date: 2014-06-02 Impact factor: 4.492
Authors: Ali Jalali; Danielle A Ryan; Kathryn E McCollister; Lisa A Marsch; Bruce R Schackman; Sean M Murphy Journal: J Subst Abuse Treat Date: 2020-03