title: Opiate and sedative dependence predicts a poor outcome for patients receiving home parenteral nutrition.
abstract: BACKGROUND
  Home parenteral nutrition (HPN) is used to treat intestinal failure. A minority of HPN patients are dependent on opiates and benzodiazepines to control pain and anxiety. The aim of this study was to determine what effects such drug dependence had on patient outcomes.
  
  
  METHODS
  Ten dependent patients were prospectively compared with 10 well-matched, nondependent HPN patients for the same 12-month period. Episodes of line sepsis and other complications were documented and the cost of treatment estimated. Health status was measured using the SF36 and EuroQol instruments.
  
  
  RESULTS
  The dependent group had significantly more episodes of central line sepsis (p = .0007) as well as other complications (p = .0002). This led to significantly longer periods of inpatient care (p = .0004) and therefore higher costs of treatment. Health status was lower in the dependent group; they reported more pain (p = .04) and less energy (p = .04).
  
  
  CONCLUSIONS
  The complication rate and increased cost of treatment for opiate- and sedative-dependent patients receiving HPN significantly detract from the overall outcome of this therapy.
authors.affiliation: Intestinal Failure Unit, Hope Hospital (University of Manchester School of Medicine), Salford, United Kingdom.
authors.forename: D M
authors.initials: DM
authors.lastname: Richards
authors.forename: N A
authors.initials: NA
authors.lastname: Scott
authors.forename: J L
authors.initials: JL
authors.lastname: Shaffer
authors.forename: M
authors.initials: M
authors.lastname: Irving
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D001569:Benzodiazepines; D005260:Female; D006304:Health Status; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000150:complications* / Q000503:physiopathology; D016331:Parenteral Nutrition, Home / Q000191:economics; D011446:Prospective Studies; D011788:Quality of Life; D019966:Substance-Related Disorders / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors
chemical_list: D014151:Anti-Anxiety Agents; D009294:Narcotics; D001569:Benzodiazepines