Improvement in quality of life after treatment for alcohol dependence with acamprosate and psychosocial support.
BACKGROUND
The impact of disease on health-related quality of life is now well recognized, as is the importance of this variable as a measure of treatment efficacy.


METHODS
Patients from five European countries were enrolled in an open, multicenter, prospective study designed to observe outcome in dependent drinkers treated for 6 months with acamprosate and psychosocial support. Version 1 of the 36-item Short Form Health Profile (SF-36v1) questionnaire was administered at inclusion and at 3 and 6 months. Responses were described as handicaps compared with an appropriately matched, healthy reference population. One-way fixed ANOVA and simultaneous stepwise linear regression analysis were used to identify potential predictors of quality of life at baseline and after treatment.


RESULTS
Baseline SF-36v1 data were obtained from 1216 patients (mean age, 43 +/- 9 years; 77% male). Mean values for all SF-36v1 dimensions were significantly lower in the patient population than in the normative reference population; the most important deficits were observed in physical and emotional role limitations and in social functioning. The most important predictors of baseline quality of life were severity of alcohol dependence, employment status, psychiatric history, quantity and frequency of alcohol consumption, attendance at Alcoholics Anonymous, global alcohol health status, age, gender, and education. SF-36v1 data were obtained from 686 patients at 3 months and from 497 at 6 months. Significant improvements were observed in all SF-36v1 dimensional and summary scores after 3 months of treatment (p < 0.001); further marginal improvements were observed between 3 and 6 months. The most important predictors of quality of life following treatment were the SF-36v1 profile at baseline, followed by abstinence duration; patients who completed the trial and remained abstinent throughout showed the greatest improvement.


CONCLUSIONS
Health-related quality of life is severly impaired in dependent drinkers. Treatment with acamprosate and psychosocial support, by promoting abstinence, improves the quality of life profile to levels comparable to those observed in healthy individuals.
Morgan
Marsha Y
MY
Centre for Hepatology, Royal Free Campus, Royal Free and University College Medical School, University College London, London, United Kingdom. mymorgan@rfc.ucl.ac.uk
Landron
Frédéric
F
Lehert
Philippe
P
D000077443:Acamprosate; D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology*; D000704:Analysis of Variance; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D013654:Taurine; D000077443:Acamprosate