Quality of life under maintenance treatment with heroin versus methadone in patients with opioid dependence
Quality of life under maintenance treatment with heroin versus methadone in patients with opioid dependence
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DOI：
10.1016/j.drugalcdep.2010.06.009
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发表时间：
2010-12-01
影响因子：
4.2
通讯作者：
Verthein, U.
中科院分区：
文献类型：
--
作者：
Karow, A.;Reimer, J.;Verthein, U.
背景 越来越多的证据表明，健康相关的生活质量 (HRQOL) 与阿片类药物成瘾的成功治疗和更好的结果相关。本研究的目的是对严重依赖患者的 HRQOL 进行纵向调查，这些患者被随机分配到四组，分别接受海洛因（二乙酰吗啡）与美沙酮以及病例管理 (CM) 与心理教育 (PSE) 治疗组。参加 Gel man 多中心研究的 938 名受试者检查了海洛因辅助治疗对严重阿片类药物依赖患者的影响。本次分析的数据取自基线和 12 个月的随访结果。结果在维持治疗和心理社会治疗两种形式下，HRQOL 在观察期内均显着改善，海洛因维持治疗下的 HRQOL 改善超过美沙酮治疗下的改善，特别是在主观身体健康方面，HRQOL 改善与更好的专家评价身体健康显着相关。结论 海洛因在改善 HRQOL 方面的优势可能部分解释为与美沙酮相比，海洛因维持下的身体健康状况得到更好的改善，这凸显了对严重阿片类药物依赖患者进行综合医疗保健模式的重要性 未来的研究需要调查 PSE 对维持治疗患者的益处 (C) 2010 Elsevier Ireland Ltd 保留所有权利
Background There is increasing evidence that health-related quality of life (HRQOL) is associated with a successful treatment and better outcome in opioid addiction the aim of the present study was the longitudinal investigation of HRQOL in patients with severe amid dependence who were randomly assigned to four groups of medical and psychosocial treatment heroin (diacetylmorphine) versus methadone and case management (CM) versus psychoeducation (PSE) respectivelyMethods HRQOL (MSQoL) and physical health (OTI) were Investigated in 938 subjects who participated in the Gel man multi-centre study examining the effects of heroin-assisted treatment in patients with severe opioid dependence Data for the present analysis were taken from baseline and 12-month follow upResults Under both forms of maintenance and psychosocial treatment HRQOL improved significantly during the observation period HRQOL improvement under maintenance with heroin exceeded improvement under methadone especially with regard to subjective physical health HRQOL improvement was significantly associated with better expert-rated physical health Further analyses showed significant better improvement of HRQOL in subjects treated with PSE compared with CMConclusions The advantage of heroin with regard to the improvement of HRQOL may be partially explained by a better Improvement of physical health under maintenance with heroin compared with methadone which highlights the importance of a comprehensive model of health care for patients with severe opioid dependence Future studies need to investigate the benefits of PSE for patients in maintenance therapy (C) 2010 Elsevier Ireland Ltd All rights reserved