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Jayamaha AR, Herath NDM, Dharmarathna ND, Sandakumari HS, Ranadeva NDK, Fernando MM, Samarakoon NAW, Amarabandu PN, Senanayake B, Darshana T, Renuka N, Samarasinghe KL, Fernando N. Health-related quality of life in patients with substance use disorders enrolled to the residential treatment in Sri Lanka: a retrospective cross-sectional study. Qual Life Res 2023; 32:435-445. [PMID: 36245018 DOI: 10.1007/s11136-022-03270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Substance use disorder (SUD) is a serious public health concern that requires continuum care with effective treatment modalities such as residential rehabilitation. Improvement in health-related quality of life (HRQoL) is one of the determinants of treatment and rehabilitation effectiveness. Therefore, a retrospective cross-sectional study was carried out in seven residential rehabilitation centres in Sri Lanka to determine the HRQoL of the rehabilitees with SUD. METHOD The HRQoL of 464 individuals at their enrolment and during the rehabilitation period was assessed using EuroQol five-level five-dimensional questionnaire (EQ-5D-5L). Data were analysed using IBM SPSS version 26. RESULTS The majority of the participants were Sinhala (n = 419, 90.3%) and Buddhist (n = 368, 79.3%) males (n = 461, 99.4%). Most were unmarried (n = 302, 65.1%), young adults (n = 385, 83.0%) who have pursued secondary or higher education (n = 276, 59.5%) and 87.3% were employed (n = 405). Most of the selected centres use biopsychosocial model (n = 4, 57.1%) as the rehabilitation approach while rest practice therapeutic community (n = 3, 42.9%). The average EQ-5D-5L index [range =( - 0.45)-1.00] of the rehabilitees at their enrolment was 0.52 ± 0.28 and the EQ-5D-5L Visual Analogue Scale (EQ-5D-5L VAS) score (range = 0-100%) was 47.17% ± 23.48%. The values were increased up to 0.83 ± 0.18 (EQ-5D-5L index) and 84.25% ± 16.79% (EQ-5D-5L VAS) during the rehabilitation period. Only 19.4% of the rehabilitees had a normal or upper normal HRQoL (≥ 0.75 EQ-5D-5L Index) at their enrolment and 72.2% of rehabilitees reported normal or upper normal HRQoL during the rehabilitation period. CONCLUSION A significant improvement in the HRQoL of the participants was observed during the residential treatment in comparison to the enrolment, despite the differences in the rehabilitation programs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Nilani Renuka
- National Dangerous Drugs Control Board, Rajagiriya, Sri Lanka
| | | | - Neluka Fernando
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Quality of life among people who use drugs living in poor urban communities in the Philippines. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 93:103160. [PMID: 33721576 DOI: 10.1016/j.drugpo.2021.103160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/08/2021] [Accepted: 02/03/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The quality of life (QOL) and mental health of people who use drugs (PWUD) in the Philippines, especially those living in poor urban communities, are highly concerning due to the situations surrounding drug use and the ongoing hard-line antidrug policy. This study aimed to investigate the QOL and mental health status of PWUD, compare them with a comparison group with no history of drug use, and identify factors associated with QOL among Filipino PWUD. METHODS A cross-sectional study was conducted with recruitment from a community-based rehabilitation programme and poor urban communities in Muntinlupa in 2018. QOL was measured using the WHOQOL-BREF, while psychological distress and posttraumatic stress disorder (PTSD) were measured using the Kessler Psychological Distress Scale (K-6) and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), respectively. Multivariable linear regressions with each WHOQOL-BREF domain as a dependent factor were conducted to establish three predictions: age- and gender-adjusted QOL means, factors associated with QOL among PWUD, and interaction of lifetime drug use with each covariate. RESULTS In total, 272 PWUD and 402 comparison participants were recruited. Most PWUD were current drug users (53%), primarily of methamphetamine (70%). Among PWUD, the prevalence of moderate to severe psychological distress was 70%, and probable PTSD was 28%-both rates higher than those among the comparison group. All four QOL domain scores (physical, psychological, social, and environmental) of PWUD were lower than those of the comparison group. Multivariable regressions showed that psychological distress, current drug use, selling drugs, experiencing discrimination, and being never-married were associated with lower QOL. Higher individual income, household resources, social activity participation, and service use for drug use problems were associated with higher QOL among PWUD. Stratified and interaction analyses revealed that the QOL of PWUD was more sensitive to changes in individual income relative to the QOL of comparison group. CONCLUSION A comprehensive intervention addressing psychological distress reduction, economic empowerment, and social inclusion-complementary to abstinence-oriented programmes-may improve the well-being of Filipino PWUD.
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Aas CF, Vold JH, Skurtveit S, Lim AG, Ruths S, Islam K, Askildsen JE, Løberg EM, Fadnes LT, Johansson KA. Health-related quality of life of long-term patients receiving opioid agonist therapy: a nested prospective cohort study in Norway. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:68. [PMID: 32883319 PMCID: PMC7469909 DOI: 10.1186/s13011-020-00309-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/25/2020] [Indexed: 01/26/2023]
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 self-perceived 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 self-perceived 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. Conclusion The average HRQoL and self-perceived health of OAT patients is significantly lower than that of the general population, and lower than what has been found among other severe somatic and psychiatric conditions. Around 34% had very good HRQoL, higher than average Norwegian values, and around 5% had extremely poor HRQoL.
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Affiliation(s)
- Christer Frode Aas
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, N-5012, Bergen, Norway. .,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Jørn Henrik Vold
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, N-5012, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Aaron G Lim
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sabine Ruths
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Kamrul Islam
- Department of Social Sciences, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Economics, University of Bergen, Bergen, Norway
| | | | - Else-Marie Løberg
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, N-5012, Bergen, Norway.,Department of Clinical Psychology, Medicine, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, N-5012, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kjell Arne Johansson
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, N-5012, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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