141st APHA Annual Meeting and Exposition

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280004
Changes in quality of life (WHO-QOLBREF) and addiction severity index (ASI) among participants in opiate substitution programs in low and middle income countries: An international systematic review


Monday, November 4, 2013

Jonathan Feelemyer, MS, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Don C. Des Jarlais, PhD, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Kamyar Arasteh, PhD, The Baron Edmond de Rothschild Chemical Dependency Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Holly Hagan, PhD, Center for Drug Use and HIV Research, New York, NY
Background: Opiate Substitution Treatment (OST) can increase quality of life (WHO-QOLBREF) and reduce addiction severity (ASI) among participants. Program participants in several studies have noted that improvements in quality of life is one of the most important factors to their reduction in drug use and associated risky behavior. However, there is little systematic understanding of WHO-QOLBREF and ASI domain changes, over time, among OST participants in low and middle-income countries (LMIC), where programs have only been recently implemented.

Methods: Utilizing PRISMA guidelines we conducted a systematic literature search to identify OST program studies that documented changes in WHO-QOLBREF or ASI domains for participants in buprenorphine or methadone programs in LMIC. Mean baseline and follow-up domain scores were calculated and compared along with relationships between domain scores, OST dosage, and treatment follow-up period.

Results: There were 13 OST program studies with 1801 participants eligible for inclusion in the review from China, Lithuania, Malaysia, Taiwan, Thailand, Vietnam, and Ukraine. Mean WHO-QOLBREF domain scores improved and mean ASI domain scores were reduced and changes were statistically significant for ASI psychological (p=0.04), family (p=0.09), and legal (p=0.03) domain scores.

Conclusion: WHO-QOLBREF and ASI are useful tools for measuring overall health, quality of life and levels of addiction among OST participants. Coupled with measurements of blood borne infection, drug use, relapse, and overdose, WHO-QOLBREF and ASI represent complimentary but equally important tools for measuring OST participants over time and should be further developed as evaluation tools in emerging programs in LMIC.

Learning Areas:

Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
Compare WHO-QOLBREF Scores among opiate substitution program participants in low income countries Compare Addiciton Severity Index (ASI) Scores among opiate substitution program participants in low income countries Evaluate mean changes in scores from baseline to follow-up among participants, compare changes to dosage of opiate substitution therapy and length of treatment follow-up Assess if low income countries see measurable and comparable changes in scores to high income countries that have evaluate the same measurements among opiate substitution program participants.

Keyword(s): Methadone Maintenance, Drug Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted systematic reviews in the field of HIV/AIDS and opiate abuse for nearly four years and have published multiple articles on topics related to this specialized population. I have also presented on similar populations at previous APHA conferences in the HIV/AIDS sections.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3395.0: Substance Abuse Treatment Programs New Approaches and Best Practices to Improve Outcomes