Ghent University, Department of Orthopedagogics, Henri Dunantlaan 2, 9000 Ghent, Belgium.
Int J Drug Policy. 2010 Sep;21(5):364-80. doi: 10.1016/j.drugpo.2010.01.010. Epub 2010 Feb 20.
Quality of life (QoL) has become an important outcome indicator in health care evaluation. A clear distinction has to be made between QoL - focussing on individuals' subjective satisfaction with life as a whole and different life domains - and health-related QoL (HRQoL), which refers to the absence of pathology. As opiate dependence is the primary drug of most persons entering treatment and as the attention for QoL in addiction research is growing, this review of the literature intends to summarise and differentiate the available information on QoL in opiate-dependent individuals. A comprehensive literature review was conducted, including database searches in Web of Science, Pubmed and Cochrane Database of Systematic Reviews. Articles were eligible for review if they assessed QoL or HRQoL of opiate-dependent individuals, used a QoL or HRQoL instrument and reported at least one specific outcome on QoL or HRQoL. In total, 38 articles have been selected. The review showed that various instruments (n=15) were used to measure QoL, mostly HRQoL instruments. Opiate-dependent individuals report low (HR)QoL compared with the general population and people with various medical illnesses. Generally, participation in substitution treatment had a positive effect on individuals' (HR)QoL, but long-term effects remain unclear. Psychological problems, older age and excessive alcohol use seem to be related with lower (HR)QoL scores. The assessment of QoL in research on opiate dependence is still in its infancy. Still, the chronic nature of drug use problems creates the necessity to look at outcomes beyond the direct consequences of drug dependence and based on clients' needs. HRQoL, with its unilateral focus on the functional status of clients, does not give information on clients' own experiences about the goodness of life, and is as a consequence unsuitable for measuring QoL. Future research starting from a subjective, multidimensional approach of the concept of QoL is required.
生活质量（QoL）已成为医疗保健评估中的一个重要结果指标。必须清楚地区分 QoL——关注个人对生活整体的主观满意度和不同的生活领域——以及与健康相关的 QoL（HRQoL），后者是指没有病理学。由于阿片类药物依赖是大多数进入治疗的人的主要药物，并且对成瘾研究中的生活质量的关注正在增加，因此对文献的综述旨在总结和区分有关阿片类药物依赖个体的生活质量的现有信息。进行了全面的文献综述，包括在 Web of Science、Pubmed 和 Cochrane 系统评价数据库中进行数据库搜索。如果文章评估了阿片类药物依赖者的生活质量或 HRQoL，使用了生活质量或 HRQoL 工具，并报告了至少一个关于生活质量或 HRQoL 的具体结果，则有资格进行审查。总共选择了 38 篇文章。综述显示，各种工具（n=15）用于测量生活质量，主要是 HRQoL 工具。阿片类药物依赖者报告的生活质量（HR）较低，与普通人群和患有各种疾病的人群相比。一般来说，替代治疗的参与对个人的（HR）生活质量有积极影响，但长期影响尚不清楚。心理问题、年龄较大和过度饮酒似乎与较低的（HR）生活质量评分有关。阿片类药物依赖研究中对生活质量的评估仍处于起步阶段。尽管如此，药物使用问题的慢性性质要求我们不仅要关注药物依赖的直接后果，还要基于客户的需求来衡量结果。HRQoL 单方面关注客户的功能状态，无法提供客户对生活质量的自身体验的信息，因此不适合衡量生活质量。需要从主观的、多维的生活质量概念方法出发开展未来的研究。
