Opioid agonist treatment reduces losses in quality of life and quality-adjusted life expectancy in heroin users: Evidence from real world data

Kun Chia Chang, Kuan Ying Lee, Tsung-Hsueh Lu, Jing Shiang Hwang, Chia Ni Lin, Shuo Yen Ting, Chih Cheng Chang, Jung-Der Wang

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalDrug and Alcohol Dependence
Volume201
DOIs
Publication statusPublished - 2019 Aug 1

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Heroin
Life Expectancy
Opioid Analgesics
Quality of Life
Quality-Adjusted Life Years
Extrapolation
Therapeutics
Statistics
Vital Statistics
Sex Distribution
Survival
Age Distribution
Health Surveys
Taiwan
Registries
Survival Rate
Interviews

All Science Journal Classification (ASJC) codes

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Chang, Kun Chia ; Lee, Kuan Ying ; Lu, Tsung-Hsueh ; Hwang, Jing Shiang ; Lin, Chia Ni ; Ting, Shuo Yen ; Chang, Chih Cheng ; Wang, Jung-Der. / Opioid agonist treatment reduces losses in quality of life and quality-adjusted life expectancy in heroin users : Evidence from real world data. In: Drug and Alcohol Dependence. 2019 ; Vol. 201. pp. 197-204.
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abstract = "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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Opioid agonist treatment reduces losses in quality of life and quality-adjusted life expectancy in heroin users : Evidence from real world data. / Chang, Kun Chia; Lee, Kuan Ying; Lu, Tsung-Hsueh; Hwang, Jing Shiang; Lin, Chia Ni; Ting, Shuo Yen; Chang, Chih Cheng; Wang, Jung-Der.

In: Drug and Alcohol Dependence, Vol. 201, 01.08.2019, p. 197-204.

Research output: Contribution to journalArticle

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

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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