Health-related quality of life trajectories of patients in heroin-assisted treatment

Background

This study investigates health-related quality of life (HRQoL) in individuals with opioid use disorder enrolled in heroin-assisted treatment (HAT). While HRQoL in opioid maintenance treatment has been studied, less is known while in HAT. This study aim is to describe HRQoL in HAT, identify different HRQoL trajectories, and examine factors associated with class memberships.

Methods

This longitudinal cohort study is based on the multi-center Norwegian HAT project. The sample includes all consenting individuals enrolled in treatment from January 2022 to October 2024 (n = 108). HRQoL was assessed using the EuroQol EQ-5D-5L, and demographics were collected at baseline and multiple time points. Latent class linear mixed models were employed to identify HRQoL trajectory classes and explore differences in class memberships.

Results

At admission, participants demonstrated significant HRQoL difficulties across all dimensions, with severity levels higher than those of the general Norwegian population, particularly in Pain/Discomfort and Anxiety/Depression. Latent class analysis identified three distinct groups: the largest group (82 %) had a stable HRQoL trajectory, while smaller groups (8 % and 10 %) showed decline and improvement, respectively. Social support, clinic location, parental origin and at least one chronic symptoms were significant predictors of class membership.

Conclusion

The diverse, lower HRQoL profiles emphasize the need for personalized healthcare and support, making the HAT setting potentially valuable for such tailored care. Treatment participation helps most maintain fairly high HRQoL. The findings confirm the critical role of supportive relationships and effective chronic condition management in HRQoL outcomes.