Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington, CT, USA; Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; New England Mental Illness, Research, Education, and Clinical Center (MIRECC), USA; Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; New England Mental Illness, Research, Education, and Clinical Center (MIRECC), USA; Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Drug Alcohol Depend. 2019 Jun 1;199:122-128. doi: 10.1016/j.drugalcdep.2019.03.004. Epub 2019 Apr 23.
To examine the association of current and past Opiate Use Disorder (OUD) with measures of HRQOL and employment in a nationally representative sample of adults.
The 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions III (NESARC III) surveyed a nationally representative sample of non-institutionalized civilian adults (≥18 years) in the US (n = 36,309 unweighted). Using DSM-5 criteria, adults without history of OUD were compared to those with current and past OUD. Using the SF-12 items, standard measures of the mental and physical component scores of HRQOL and of quality-adjusted life years (QALYs) were constructed. Employment in the past year (yes/no) was also assessed. Multivariable-adjusted regression analyses were used to adjust for covariates.
Overall, 0.9% of the study sample, representing 2.1 of 235.4 million adults, met criteria for current OUD; 1.2%, representing 2.7 million adults, met criteria for past OUD. Adults with current or past OUD had large and moderately reduced mental component (MCS) and physical health component (PCS) summary scores compared to adults who never had OUD (p < 0.001, respectively). Current OUD was associated with lower odds of being employed compared to never experiencing OUD (Adjusted odds ratio = 0.65; 95% CI: 0.48, 0.88; p = 0.005), as was past OUD. Adjustment for potentially confounding factors reduced the independent association of OUD and HRQOL by about 40-50% but did not change employment comparisons.
Adults with current OUD are associated with large reductions in HRQOL and likelihood of not being employed, and adults with past OUD also have considerable residual impairment.
在一个具有全国代表性的成年人样本中，研究当前和过去的阿片类药物使用障碍（OUD）与健康相关生活质量（HRQOL）和就业测量值之间的关系。
2012-2013 年全国酒精相关情况和条件调查 III（NESARC III）调查了美国（未加权 n=36,309）非机构化的平民成年人（≥18 岁）的全国代表性样本。使用 DSM-5 标准，将没有 OUD 病史的成年人与当前和过去有 OUD 的成年人进行比较。使用 SF-12 项目，构建了 HRQOL 的心理和生理成分评分以及质量调整生命年（QALYs）的标准测量值。还评估了过去一年的就业情况（是/否）。使用多变量调整回归分析来调整协变量。
总体而言，研究样本中有 0.9%的人，即 23540 万成年人中有 2.1 人，符合当前 OUD 的标准；1.2%的人，即 270 万成年人，符合过去 OUD 的标准。与从未有过 OUD 的成年人相比，当前或过去有 OUD 的成年人的心理成分（MCS）和身体健康成分（PCS）综合评分都有较大且适度降低（p<0.001，分别）。与从未经历过 OUD 相比，当前 OUD 与就业的可能性较低相关（调整后的优势比=0.65；95%置信区间：0.48，0.88；p=0.005），过去 OUD 也是如此。调整潜在混杂因素后，OUD 和 HRQOL 的独立相关性降低了约 40-50%，但就业比较没有改变。
当前有 OUD 的成年人的 HRQOL 大幅降低，且就业的可能性降低，过去有 OUD 的成年人也有相当大的残余损伤。
