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Bogdanowicz, Karolina Magda, Stewart, Robert, Chang, Chin-Kuo, Downs, Johnny, Khondoker, Mizanur 
ORCID: https://orcid.org/0000-0002-1801-1635, Shetty, Hitesh, Strang, John and Hayes, Richard Derek
(2016)
Identifying mortality risks in patients with opioid use disorder using brief screening assessment:Secondary mental health clinical records analysis.
Drug and Alcohol Dependence, 164.
pp. 82-88.
ISSN 0376-8716
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Abstract
BACKGROUND: Risk assessments are widely used, but their ability to predict outcomes in opioid use disorder (OUD) treatment remains unclear. Therefore, the aim was to investigate if addiction-specific brief risk screening is effective in identifying high mortality risk groups and if subsequent clinical actions following risk assessment impacts on mortality levels. METHODS: Opioid use disorder (OUD) patients were identified in the South London and Maudsley Case Register. Deaths were identified through database linkage to the national mortality dataset. Cox and competing-risk regression were used to model associations between brief risk assessment domains and all-cause and overdose mortality in 4488 OUD patients, with up-to 6-year follow-up time where 227 deaths were registered. Data were stratified by admission to general mental health services. RESULTS: All-cause mortality was significantly associated with unsafe injecting (HR 1.53, 95% CI 1.10-2.11) and clinically appraised likelihood of accidental overdose (HR 1.48, 95% CI 1.00-2.19). Overdose-mortality was significantly associated with unsafe injecting (SHR 2.52, 95% CI 1.11-5.70) and clinically appraised suicidality (SHR 2.89, 95% CI 1.38-6.03). Suicidality was associated with a twofold increase in mortality risk among OUD patients who were not admitted to mental health services within 2 months of their risk assessment (HR 2.03, 95% CI 1.67-3.24). CONCLUSIONS: Diagnosis-specific brief risk screening can identify OUD patient subgroups at increased risk of all-cause and overdose mortality. OUD patients, where suicidality is evident, who are not admitted into services are particularly vulnerable.
| Item Type: | Article |
|---|---|
| Additional Information: | © 2016 The Author(s). Published by Elsevier Ireland Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Uncontrolled Keywords: | opioids,heroin,treatment,mortality,risk assessment,suicide,overdose,injecting,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Population Health |
| Depositing User: | Pure Connector |
| Date Deposited: | 24 Sep 2016 00:10 |
| Last Modified: | 19 Oct 2023 01:44 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/59888 |
| DOI: | 10.1016/j.drugalcdep.2016.04.036 |
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