Study to determine relevant health outcome measures in opioid use disorder: Multicriteria decision analysis

The aim of the current study was to establish the most relevant health outcomes to assess opioid substitution treatment programmes (OSP) in patients with opioid use disorder (OUD) in Spain. A multicriteria decision analysis was applied in 3 phases: 1) concepts and criteria definitions; 2) criteria screening and weighting by means of a discrete choice experiment; 3) deliberative process. Criteria established in phase 1 were: substance use (opioids, alcohol, tobacco, stimulants and cannabis), other mental disorders (affective/anxiety disorder, psychosis, attention deficit hyperactivity disorder, borderline personality disorder, antisocial personality disorder, gambling disorder and other impulse control disorders), level of disability, adherence, medical illnesses (medical comorbidities, risk behaviours, infectious and sexually transmitted diseases), psychosocial aspects (hostile and/or violent behaviour and work problems), functional disability (quality of life, treatment and service satisfaction, social functionality). In phase 2, the most relevant factors in OSP were determined, and subsequently assessed in the deliberative process: remission of substance use (opioids, alcohol and stimulants), improvement of other mental disorders (psychosis and borderline personality disorder), improvement in comorbidity management, and improvement in social functionality, with a weighting of 56.5%, 21.9%, 11.0%, and 10.7%, respectively. The current analysis defines the main health outcomes in OSP in patients with OUD in Spain, supporting decision making and socio-health management of existing resources.