Quality of life and treatment effectiveness direct and indirect effects on cocaine abstinence outcomes during cocaine use disorder treatment

IF 3.5 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2026-01-01 Epub Date: 2025-11-28 DOI:10.1016/j.drugalcdep.2025.112993

Crystal L. Smith , Sterling M. McPherson , Nicole Rodin , Sean E. Hovland , Nicole Akana , Andre QC Miguel , John Marsden , Andrew J. Saxon

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引用次数: 0

Abstract

Background

Patient-perceived Quality-of-Life (QOL) and treatment effectiveness (TEA) have previously been shown to be positively associated with better substance use treatment outcomes.

Objectives

This study examined potentially causal relationships amongst QOL, TEA, and cocaine abstinence.

Methods

Secondary data analyses (CTN-0148) were conducted on the NIDA Clinical Trial Network study, Cocaine Use Reduction with Buprenorphine (CTN-0048). N = 301 participants with DSM-IV cocaine dependence and opioid use history were administered injectable naltrexone and randomized to one of three buprenorphine/naloxone doses, 4 mg/1 mg, 16 mg/4 mg or placebo. Mediation models estimated direct and indirect effects amongst QOL, TEA, and cocaine abstinence.

Results

The QOL Environment domain exerted a significant indirect effect (B=0.01, SE=0.01, 95 % CI=[0.00, 0.02]) on cocaine abstinence and a direct effect on TEA (B=0.57, SE=0.22, 95 % CI=[0.16, 1.01]). Other QOL domains and individual QOL items exerted no statistically significant direct effects on cocaine abstinence. Overall QOL exerted a significant direct effect on TEA (95 % CI=[0.32, 2.45]) along with a significant indirect effect on cocaine abstinence (95 % CI=[0.01, 0.05]). TEA had a significant positive direct effect on cocaine abstinence (95 % CI=[0.01, 0.02]).

Conclusion

Overall QOL and environmental QOL are related to treatment response through their relationship with patients’ perception of treatment effectiveness. TEA is directly related to cocaine abstinence at the end of treatment. QOL and TEA measures may serve as indicators of a need for additional support within care plans. These findings highlight the impact of a patient’s sense of well-being and their perceived treatment effectiveness on biochemically validated cocaine abstinence.

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生活质量和治疗效果对可卡因使用障碍治疗期间可卡因戒断结果的直接和间接影响

患者感知的生活质量（QOL）和治疗有效性（TEA）先前已被证明与更好的药物使用治疗结果呈正相关。目的本研究探讨了生活质量、TEA和可卡因戒断之间的潜在因果关系。方法对NIDA临床试验网络研究丁丙诺啡减少可卡因使用（CTN-0048）进行二次数据分析（CTN-0148）。301名具有DSM-IV可卡因依赖和阿片类药物使用史的参与者给予注射纳曲酮，并随机分为三种丁丙诺啡/纳洛酮剂量，4mg / 1mg， 16mg / 4mg或安慰剂。中介模型估计了生活质量、茶和可卡因戒断之间的直接和间接影响。结果QOL环境域对可卡因戒断有显著的间接影响（B=0.01， SE=0.01, 95% CI=[0.00, 0.02]），对TEA有显著的直接影响（B=0.57， SE=0.22, 95% CI=[0.16, 1.01]）。其他生活质量领域和个别生活质量项目对可卡因戒断没有显著的直接影响。总体生活质量对TEA有显著的直接影响（95% CI=[0.32, 2.45]），对可卡因戒断有显著的间接影响（95% CI=[0.01, 0.05]）。TEA对可卡因戒断有显著的正向直接影响（95% CI=[0.01, 0.02]）。结论总体生活质量和环境生活质量通过与患者对治疗效果的感知关系与治疗反应相关。TEA与治疗结束时的可卡因戒断有直接关系。生活质量和TEA测量可以作为护理计划中需要额外支持的指标。这些发现强调了患者的幸福感和他们感知到的治疗效果对生物化学验证的可卡因戒断的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.