TY - JOUR
T1 - Opioid agonist treatment reduces losses in quality of life and quality-adjusted life expectancy in heroin users
T2 - Evidence from real world data
AU - Chang, Kun Chia
AU - Lee, Kuan Ying
AU - Lu, Tsung Hsueh
AU - Hwang, Jing Shiang
AU - Lin, Chia Ni
AU - Ting, Shuo Yen
AU - Chang, Chih Cheng
AU - Wang, Jung Der
N1 - Funding Information:
This project is was supported by grants from the Ministry of Health and Welfare, Executive Yuen, Taiwan ( MOHW-10646 , MOHW-10243 , MOHW-10740 , MOHW-10444 and MOHW-10445 ) and partially supported by the following grants funded by the Ministry of Science and Technology, Executive Yuen, Taiwan ( MOST 106-2627-M-006-015 and MOST 107-2627-M-006-007 ). The funder has no role in the study design, data analysis, or preparation of this manuscript.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background: This study estimated the long-term changes of opioid agonist treatment (OAT) in quality of life (QOL) and quantified the quality-adjusted life years (QALY) from the loss of quality-adjusted life expectancy (QALE) in heroin users. Methods: A total of 1283 heroin users stratified by OAT were linked to the National Mortality Registry for 8 years (2006–2014) to obtain survival functions, which were extrapolated to lifetime by applying a rolling extrapolation algorithm to survival ratio between the sub-cohorts and age- and sex-matched referents simulated from vital statistics of Taiwan. We performed cross-sectional measurement of EQ-5D on 349 participants, including those with a valid state of OAT or non-OAT plus newly recruited consecutive patients, during 2015–2017 for utility values, while the QOL of referents were abstracted from the 2009 National Health Interview Survey. The QALE was calculated by summing the products of the mean QOL and survival rate throughout life. The QALE difference between the cohort and corresponding referents was the loss-of-QALE. Results: QOL of the OAT group was significantly better than that of the non-OAT group in every domain of the EQ-5D, which was quantified to be 0.23 for utility after controlling for other variables. After extrapolation to 70 years, the estimated QALE and loss-of-QALE were 17.8 and 18.2 QALY for OAT subjects, respectively, while those of the non-OAT group were 9.2 and 27.9 QALY. Conclusions: Receiving OAT could reduce QALE lost by 9.7 QALYs compared with non-OAT after accounting for QOL differences along time and different age and sex distributions.
AB - Background: This study estimated the long-term changes of opioid agonist treatment (OAT) in quality of life (QOL) and quantified the quality-adjusted life years (QALY) from the loss of quality-adjusted life expectancy (QALE) in heroin users. Methods: A total of 1283 heroin users stratified by OAT were linked to the National Mortality Registry for 8 years (2006–2014) to obtain survival functions, which were extrapolated to lifetime by applying a rolling extrapolation algorithm to survival ratio between the sub-cohorts and age- and sex-matched referents simulated from vital statistics of Taiwan. We performed cross-sectional measurement of EQ-5D on 349 participants, including those with a valid state of OAT or non-OAT plus newly recruited consecutive patients, during 2015–2017 for utility values, while the QOL of referents were abstracted from the 2009 National Health Interview Survey. The QALE was calculated by summing the products of the mean QOL and survival rate throughout life. The QALE difference between the cohort and corresponding referents was the loss-of-QALE. Results: QOL of the OAT group was significantly better than that of the non-OAT group in every domain of the EQ-5D, which was quantified to be 0.23 for utility after controlling for other variables. After extrapolation to 70 years, the estimated QALE and loss-of-QALE were 17.8 and 18.2 QALY for OAT subjects, respectively, while those of the non-OAT group were 9.2 and 27.9 QALY. Conclusions: Receiving OAT could reduce QALE lost by 9.7 QALYs compared with non-OAT after accounting for QOL differences along time and different age and sex distributions.
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U2 - 10.1016/j.drugalcdep.2019.05.003
DO - 10.1016/j.drugalcdep.2019.05.003
M3 - Article
C2 - 31247504
AN - SCOPUS:85067605071
VL - 201
SP - 197
EP - 204
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
SN - 0376-8716
ER -