Department of Psychology, Faculty of Natural Sciences, MSB Medical School Berlin MSB Medical School Berlin, Berlin, Germany.
Charité Center 15 for Neurology, Neurosurgery and Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany.
Eur Addict Res. 2021;27(5):371-380. doi: 10.1159/000514192. Epub 2021 Mar 30.
Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options.
Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (n = 126), diamorphine (n = 85), or buprenorphine (n = 37) were recruited in 6 German therapy centers.
Sociodemographic data were collected. QoL - physical and psychological functioning - for different substitutes was assessed using the Profile of the Quality of Life in the Chronically Ill (PLC) questionnaire.
Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (p < 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (p < 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (p < 0.001, η2 = 0.141). Diamorphine patients reported a higher psychological functioning (p < 0.001, η2 = 0.078) and overall life improvement (p < 0.001, η2 = 0.060) compared to methadone, but not compared to buprenorphine patients (both p > 0.25).
Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.
对慢性病患者生活质量（QoL）的研究为评估长期治疗效果提供了机会。虽然阿片类药物替代疗法被证实是治疗阿片类药物依赖患者的有效方法，但对于不同治疗选择的 QoL 身体和心理功能知之甚少。
总共招募了 6 家德国治疗中心的 248 名接受替代治疗的阿片类药物依赖患者，分别接受美沙酮/左美沙酮（n = 126）、海洛因（n = 85）或丁丙诺啡（n = 37）治疗。
收集社会人口统计学数据。使用慢性疾病患者生活质量概况（PLC）问卷评估不同替代品的 QoL-身体和心理功能。
患者组在年龄和阿片类药物依赖时间方面相似。丁丙诺啡组（46%）的就业率显著更高（p < 0.005，φ = 0.22），而美沙酮组（18%）则较低。剂量调整在海洛因组（55%）比美沙酮组（30%）或丁丙诺啡组（19%）更频繁（p < 0.001，φ = 0.29）。丁丙诺啡和海洛因患者的身体功能评分明显高于美沙酮患者（p < 0.001，η2 = 0.141）。与美沙酮相比，海洛因患者报告心理功能（p < 0.001，η2 = 0.078）和整体生活改善（p < 0.001，η2 = 0.060）更高，但与丁丙诺啡患者相比则无差异（均 p > 0.25）。
对接受美沙酮/左美沙酮、海洛因和丁丙诺啡替代物的患者进行重要 QoL 方面的测量表明，身体和心理功能存在显著差异。这对于阿片类药物成瘾的差异化治疗可能具有重要意义。
