Health-Related Quality of Life of People Who Inject Drugs: The Enhancing Treatment of Hepatitis C in Opioid Substitution Settings Engage Study

Qinglu Cheng; Heather Valerio; Evan B Cunningham; Sophy T F Shih; David Silk; Anna Conway; Carla Treloar; Carolyn Murray; Charles Henderson; Janaki Amin; Phillip Read; Gregory J Dore; Jason Grebely; ETHOS Engage Study Group

doi:10.1016/j.jval.2023.10.013

Health-Related Quality of Life of People Who Inject Drugs: The Enhancing Treatment of Hepatitis C in Opioid Substitution Settings Engage Study

Value Health. 2024 Feb;27(2):216-225. doi: 10.1016/j.jval.2023.10.013. Epub 2023 Nov 10.

Authors

Collaborators

ETHOS Engage Study Group:
Jason Grebely, Gregory J Dore, David Silk, Nicky Bath, Carla Treloar, Andrew Milat, Adrian Dunlop, Janaki Amin, Jo Holden, Carolyn Murray, Charles Henderson, Kyle Leadbeatter, Emma Day, Nikitah Habraken, Olivia Dawson, Louisa Degenhardt, Clarke Scott, Phillip Read, Jason Grebely, Gregory J Dore, David Silk, Heather Valerio, Shane Tillakeratne, Philippa Marks, Indika Jayasinghe, Maria Martinez, Hannah Reid, Valerie Gleeson, Jodi Van Dyk, Gerard Estivill Mercade, Alison D Marshall, Stephanie Obeid, A Wheeler, Samira Hosseini Hooshyar, Beth Catlett, Andrey Verich, Anna Conway, Amanda Erratt, Alice Wheeler, Nadine Ezard, David Reid, Carla Gorton, Jeremy Hayllar, Thao Lam, Adrian Dunlop, Prasun Datta, Alex Wade, Sally Spruce, Vicky Cock, Mark Cornwell, Krista Zohrab, Michael Christmass, Craig Connelly, Angela Cooper, Mark Montebello, Robert Cherry, Julie Dyer, Shikha Arawal, Elke Press, Nadine Horasak, Rhondda Lewis, Astrid Carthew, Daniel Morris, Kathy Donohue, Kathy Griffiths, Jason Dalla Lana, Sue Shin, Connie Graf, Adele Hampson, Siyu Qian, Danielle Brown, Amber Lautier, Cate Curran, Carina Burns, Ravina Raidu, Kylie Stolzenhein, Wanda Brabender, Kelly Somes, Nargis Abram, Rick Turne, Stuart Larter, Fiona Goodberg, Jennifer Luksza, Michelle Hall, Susan Hazelwood, Charlotte Ismay, Krista Zohrab, Belinda McClurg, Cherie Mincham, Kali Barlow, Anita Hoskins, Kate Salisbury, Julie Markham, Jacky Talmet, Sandy Dunn, Amanda Mitchell, Andrew McKinnon, Fionnualh Smyth, Lisa Snell, Elizabeth Laing, Martin Clark, Justin Dorigo, Louise Carman, Brent Fergusson, Bonny Puszka, Gai Duncan, Fiona Baker, Jayde Walsh, Leeann Walsh, Sara Adey, Rodd Hinton, Melanie Joyce, Cheryl Woods, Alain Jenart, Hope Everingham, Louisa Jansen, Lucy Pepolim, Kathy Clark, Lyn Murphy, Joel Iliffe

Affiliations

¹ The Kirby Institute, University of New South Wales, Sydney, NSW, Australia. Electronic address: qcheng@kirby.unsw.edu.au.
² The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
³ The Kirby Institute, University of New South Wales, Sydney, NSW, Australia; Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia.
⁴ Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia.
⁵ Population Health Strategy and Performance, NSW Health, St Leonards, NSW, Australia.
⁶ NSW Users and AIDS Association, Glebe, NSW, Australia.
⁷ The Kirby Institute, University of New South Wales, Sydney, NSW, Australia; Department of Health Sciences, Macquarie University, Sydney, NSW, Australia.
⁸ Kirketon Road Centre, Sydney, NSW, Australia.

PMID: 37951538
DOI: 10.1016/j.jval.2023.10.013

Abstract

Objectives: There is limited research on health-related quality of life (HRQoL) among people who inject drugs (PWID). We evaluated the HRQoL and associated factors among a cohort of PWID in Australia.

Methods: Participants were enrolled in an observational cohort study (the Enhancing Treatment of Hepatitis C in Opioid Substitution Settings Engage Study) from May 2018 to September 2019 (wave 1) and November 2019 to June 2021 (wave 2). Participants completed the EQ-5D-5L survey at enrolment. Two-part models were used to assess the association of clinical and socioeconomic characteristics with EQ-5D-5L scores.

Results: Among 2395 participants (median age, 43 years; 66% male), 65% reported injecting drug use in the past month, 20% had current hepatitis C virus (HCV) infection, and 68% had no/mild liver fibrosis (F0/F1). Overall, the mean EQ-5D-5L and EQ-visual analog scale scores were 0.78 and 57, respectively. In adjusted analysis, factors associated with significantly lower EQ-5D-5L scores include older ages, female (marginal effect = -0.03, P = .014), being homeless (marginal effect = -0.04, P = .040), and polysubstance use (marginal effect = -0.05, P < .001). Factors associated with significantly higher EQ-5D-5L scores were being Aboriginal/Torres Strait Islander (marginal effect = 0.03, P = .021) and recent injecting drug use in the past 12 months. Current HCV infection and liver fibrosis stage were not associated with reduced HRQoL among the study participants.

Conclusions: PWID experienced a lower HRQoL compared with the general population. Further research is needed to understand HRQoL in this population to facilitate the development of multifaceted care models for PWID beyond HCV cure and inform health economic analyses for identifying optimal health strategies for PWID.

Keywords: EQ-5D-5L; health-related quality of life; hepatitis C; people who inject drugs.

Publication types

Observational Study

MeSH terms

Adult
Analgesics, Opioid / therapeutic use
Drug Users*
Female
Hepacivirus
Hepatitis C* / drug therapy
Hepatitis C* / epidemiology
Humans
Liver Cirrhosis
Male
Quality of Life
Substance Abuse, Intravenous* / complications
Substance Abuse, Intravenous* / epidemiology
Surveys and Questionnaires

Substances

Analgesics, Opioid