Kan heroinassistert behandling gi økt livskvalitet?

This project will investigate quality of life (QoL) changes in patients undergoing heroin- assisted treatment (HAT)

– HAT consists of the prescription of diacetylmorphine (pharmaceutical heroin) under highly regulated treatment conditions. This treatment is specifically aimed at individuals with opioid use disorder where regular opioid agonist treatment was not sufficient for the patient.

– We will do so by collecting questionnaire data at different points in time for each HAT patient. In addition to analyzing the repeated measure data, we will also analyze it together with registry data. Ultimately, we aim to describe how treatment affects QoL for the patients.

– The project will also include the development and piloting of a repeated measurement tool to monitor day-to-day changes in the QoL as patients experience treatment.

Why is this important?

– The inclusion of HAT as part of the opioid agonist treatment option in Norway is a new approach. Therefore, this also offers great potential for establishing new knowledge about this treatment.

– This research will also contribute to a broader evaluation of this new treatment and how patients respond to it in Norway. Such information will be important for the patient, their families as well as health professionals, health trusts and decision-makers.

– Moreover, as opioid use disorder is a chronic condition with cycling disease intensity, it is essential to monitor one of the primary goals of treatment: the maintenance of or improvement of QoL. The focus on QoL could help in tailoring treatment to patients’ individual characteristics and needs as to have a more patient-centered care.

What do you want to find out?

– The aim of the project is to describe whether and how QoL changes during the treatment. Further, we are interested in identifying any factors associated with better QoL scores and increased retention in HAT. Factors concerning socio-economic characteristics, treatment related aspects and other from external domains such as healthcare utilization, drug use, and criminal activity will be explored.

– In addition, we would like to explore if these QoL changes and patterns can be identified in real time through frequent measurement and how feasible the use of such indicator could be for the day-to-day tailoring of the treatment.

How will the project be carried out? Do you have a schedule?

– The project on QoL will be carried out over 3 years, from 2022 to 2025 with an ongoing data collection. Patients’ recruitment to the study started concurrently with the first patients enrolling to HAT in the two recently opened clinics in Oslo and Bergen in January 2022. The data collection is also going to continue for the entire duration of the project as patients are followed at different points in time: 3 months, 6 months, and at every year time point. The data will be analyzed, and the results disseminated through scientific publications (planned one every year) and presentations until project end.

– In addition, in 2023 it is planned to develop and pilot the repeated scale-based measurement tool that will allow the monitoring of day-to-day changes of patients’ QoL.

What is your hypothesis?

– It is expected that patients will experience QoL changes throughout their HAT experience and that better QoL scores will be measured since treatment admission. It is hypothesized that patients with the most improvement in QoL will stabilize more quickly and stay longer in treatment than those who experience less improvements.

– Lack of improvements or reduced QoL may offer insights on areas that should be addressed more effectively in the individual treatment plans so to better suit patients’ needs.

Who has initiated the project, and who is involved?

– The project is initiated and organized by SERAF at the University of Oslo, and is a collaboration between SERAF, Section for Clinical Addiction Research /Oslo University Hospital (RusForsk) and Bergen Addiction Research/ University of Bergen (BAR) , the Center for Substance Abuse Research at Aarhus University and the user organizations ProLARnett and Foreningen for Human Narkotikapolitikk (FHN).

Stiftelsen Dam makes demands for user participation. How is that taken care of in this project?

– The project has a collaboration with users organizations Foreningen for Human Narkotikapolitikk (FHN) and proLARNett which have the essential role of assisting in the recruitment to the study, as well as providing occasional peer support in the clinics.

– Regular meetings with FHN and proLARNett representatives are carried out and planned regularly though the study period. Their valuable feedback and suggestions ensure that the user perspective is included in all phases of the research project.

– In particular the daily measurement tool will be developed and piloted in close contact with user organizations to better address the needs and requirements of the patients.