OPIATE AND SEDATIVE DEPENDENCE PREDICTS A POOR OUTCOME FOR PATIENTS RECEIVING HOME PARENTERAL-NUTRITION

Background: Home parenteral nutrition (HPN) is used to treat intestina l failure. A minority of HPN patients are dependent on opiates and ben zodiazepines 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 we ll-matched, nondependent HPN patients for the same 12-month period. Ep isodes 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 significant ly more episodes of central line sepsis (p = .0007) as well as other c omplications (p = .0002). This led to significantly longer periods of inpatient care (p = .0004) and therefore higher costs of treatment. He alth status was lower in the dependent group; they reported more pain (p = .04) and less energy (p = .04). Conclusions: The complication rat e and increased cost of treatment for opiate-and sedative-dependent pa tients receiving HPN significantly detract from the overall outcome of this therapy.