Towards More Effective Public Health Programming for Injection Drug Users: Development and Evaluation of the Injection Drug User Quality of Life Scale

Abstract

The psychometric properties of the Injection Drug User Quality of Life Scale (IDUQOL) were assessed in 61 Montreal IDUs in 2001, 85% of whom were reinterviewed within four weeks. The reliability of the IDUQOL was acceptable (ICC = 0.71) and concordance between the IDUQOL and the Flanagan Quality of Life Scale was moderate (Pearson coefficient = 0.57). Quality of life was negatively associated with injection cocaine and emergency department use with both instruments; these results were more striking for the IDUQOL. The IDUQOL is a culturally relevant quality of life instrument with good psychometric properties. The IDUQOL may be useful in the development and evaluation of interventions for IDUs.

• Quality of life
• Injection drug users
• Psychometric properties
• Evaluative study

Résumé

Les caractéristiques de l’IDUQOL on été évaluées parmi 61 utilisateurs des drogues par injection (UDIs) montréalais en 2001; 85% de ceux-ci ayant été reinterviewés à l’intérieur d’une période de quatre semaines. La fiabilité de l’IDUQOL était acceptable (ICC = 0.71) et la concordance entre l’IDUQOL et l’échelle de qualité de vie de Flanagan était modérée (correlation de Pearson = 0.57). La qualité de vie, telle que mesurée par les deux instruments, avait une association négative avec l’injection de la cocaïne et l’utilisation des urgences. Ces résultats étaient plus marqués avec l’IDUQOL. L’IDUQOL est une échelle de la qualité de vie qui a de bonnes caractéristiques psychométriques et qui semble adaptée culturellement aux UDIs. L’IDUQOL pourrait s’avérer utile dans le développement et l’évaluation des interventions auprès des UDIs.

Additional information

Notes on contributors

Susan Brogly

Susan Brogly, M.Sc. is a Ph.D. student in the Department of Epidemiology and Biostatistics at McGill University in Montreal, Canada. She has been conducting research on injection drug users since 1997, and has been leading the investigation on the Injection Drug User Quality of Life Scale in Montreal injectors for her doctoral thesis. Susan's work at a community organization for people living with HIV/AIDS greatly complements her research and understanding of HIV and of drug addiction. She holds a Doctoral Award from the Canadian Institutes of Health Research.

Céline Mercier

Céline Mercier, Ph.D. is Associate Professor at the Department of Psychiatry, McGill University, Director of the Research and Information Technologies Department at the Lisette-Dupras Rehabilitation Center, and Senior Consultant at the Montreal WHO Collaborating Centre. Her areas of interest in research pertain to organization and evaluation of services in mental health and mental retardation, alcoholism and drug abuse, and homelessness. As a consultant to WHO she has primarily worked on quality of life, quality assurance, and implementation of reform in mental health services.

Julie Bruneau

Dr. Julie Bruneau, M.D. is Clinical Associate Professor in the Departments of Psychiatry and of Family Medicine, Université de Montréal. She is an addiction medicine physician at Hôpital Saint-Luc, Centre Hospitalier de l’Université de Montréal and coprincipal investigator of a multidisciplinary cohort study examining the factors and processes associated with HCV and HIV transmission in Montreal and Vancouver, Canada. Julie is also an investigator of the Canadian Network for Vaccines and Immunotherapeutics (CANVAC), and OPICAN, a multisite study on opiate use in Canada. She has published extensively in public health journals on the Canadian experience of HIV transmission among injection drug users.

Anita Palepu

Dr. Anita Palepu, M.D., M.P.H., F.R.C.P.C. works at the Centre for Health Evaluation and Outcome Sciences. As a CIHR New Investigator (AIDS), her research focuses on access to care, health care utilization, and health status of vulnerable populations such as injection drug users at risk for HIV infection. Dr. Palepu was awarded a CIHR operating grant in 2002 to further validate the Injection Drug User Quality of Life Scale. She collaborates closely with her colleagues at the Centre for Excellence in HIV/AIDS and her other projects address the barriers to accessing and sustaining antiretroviral therapy in HIV-positive injection drug users, and issues pertaining to harm reduction. She is currently collaborating with researchers at Boston University to study the effect of substance abuse treatment on health care utilization, and antiretroviral therapy uptake and adherence among HIV-infected persons with alcohol problems. In addition, she is an Associate Editor for the Canadian Medical Association Journal.

Eduardo Franco

Dr. Eduardo L. Franco, Ph.D., is Professor of Epidemiology and Oncology and Director, Division of Cancer Epidemiology at McGill University's Faculty of Medicine, in Montreal, Canada. His research since 1985 has focused on the molecular epidemiology and prevention of cervical cancer, upper aerodigestive tract cancers and childhood tumors, HIV epidemiology, and the development of epidemiological methods in the evaluation of screening efficacy and assessment of the impact of measurement errors. He has published over 190 scientific articles and chapters and edited two books on cancer epidemiology and prevention. Dr. Franco is recipient of a Distinguished Scientist Award from the Canadian Institutes of Health Research, and of a National Research Scholar Award from the Fonds de la Recherche en Santé du Quebec.