Quality of Life as an Outcome of Opioid Use Disorder Treatment

The recent opioid epidemic has prompted renewed interest in opioid use disorder treatment, but there is little evidence regarding health-related quality-of-life (HRQoL) outcomes in treatment programs. Measuring HRQoL represents an opportunity to consider outcomes of opioid use disorder treatment that are more patient-centered and more relevant to overall health than abstinence alone.

This systematic literature review explores the extent to which the collection of HRQoL by opioid treatment programs is documented in the treatment program literature. PubMed, Embase PsycINFO and Web of Science were searched for papers published between 1965 and 2015 that reported HRQoL outcome measures from substance abuse treatment programs. Of the 3014 unduplicated articles initially identified for screening, 99 articles met criteria for further review. Of those articles, 7 were unavailable in English; therefore 92 articles were reviewed. Of these articles, 44 included any quality-of-life measure, 17 of which included validated HRQoL measures, and 10 supported derivation of quality-adjusted life year utility weights. The most frequently used validated measure was the Addiction Severity Index (ASI). Non-U.S. and more recent studies were more likely to include a measure of HRQoL.

The authors found that HRQoL measures are rarely used as outcomes in opioid treatment programs. They recommend that the field should incorporate HRQoL measures as standard practice, especially measures that can be used to derive utility weights, such as the SF-12 or EQ-5D. These instruments provide policy makers with evidence on the impact of programs on patients' lives and with data to quantify the value of investing in opioid use disorder treatments.