Does drug treatment improve patient quality of life? A pilot study of the outcomes of the quality of life assessment in New York City outpatient and opioid treatment programs
© Nass et al; licensee BioMed Central Ltd. 2015
Published: 20 February 2015
The Affordable Care Act and the Medicaid redesign in New York City offer opportunities to explore alternative methods for measuring the effectiveness of behavioral health interventions. Quality of life (QOL) measures have been underutilized in substance use disorders treatment (SUDT). The objective of this study was to determine how a validated QOL instrument could be used in SUDT as a measure of health-related patient outcomes.
NYC outpatient drug treatment (DT) and opioid treatment programs (OTP) were invited to participate in a pilot evaluation. Newly admitted patients completed counselor-administered surveys at admission, and 90 and 180 days. Surveys included demographic (gender, age, race, language) and clinical items (homelessness, criminal justice involvement, mandated treatment, major health conditions, substance of choice, frequency of use) in addition to the World Health Organization QOL instrument, the WHOQOL-BREF . The WHOQOL-BREF is a 26-item, validated questionnaire that measures QOL in four domains: physical, psychological, social, and environment. Domain-specific QOL scores were calculated, transformed, and compared with healthy and chronically ill populations from the literature ; scoring was on a scale of 0 to 100 for each domain. We compared mean domain scores between baseline and follow-up intervals for available participants, and by demographic and clinical characteristics using ANOVA and t-tests. We examined change in QOL scores among OTP participants stratified by major health conditions.
Participant Demographic Characteristics (N = 1269)
Under age 45
Any criminal justice involvement
Major physical or mental health condition
Domain-specific mean QOL scores at baseline, 90, and 180 days*
Baseline (n = 1262)
90 Day (n = 616)
180 Day (n = 336)
Preliminary findings indicate that individuals in SUDT have lower QOL scores than healthy populations and experience improvements in QOL during treatment. Small positive changes among individuals with health conditions suggest the importance of integrating physical health care with SUDT. High dropout rates, multiple survey administrators, and an English-only survey instrument may limit our conclusions. Future investigations need to examine the feasibility of incorporating QOL measures into SUDT more broadly, including its impact on clinical interventions and longer-term patient outcomes, including maintenance of QOL gains achieved during SUDT.
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