ObjectivesOpioid consumption in France has remained stable over the last 15 years, with much lower levels than in the USA. However, few data are available on patients who consume opioids and their use of the health system. Emergency department (ED) data has never been used as a source to investigate opioid use disorder (OUD) in France.Design/settings/participantsWe used the OSCOUR national surveillance network, collecting daily ED data from 93% of French ED, to select and describe visits and hospitalisations after an OUD-related ED visit between 2010 and 2018 using International Classification of Diseases, version 10 (ICD10) codes. We described the population of interest and used binomial negative regressions to identify factors significantly associated with OUD such as gender, age, administrative region, year of admission and ICD10 codes. We also analysed the related diagnoses.Primary outcome measureTrend in ED visits for an OUD-related ED visit.ResultsWe recorded 34 362 OUD-related visits out of 97 892 863 ED visits (36.1/100 000 visits). OUD-related visits decreased from 39.2/100 000 visits in 2010 to 32.9/100 000 visits in 2018, resulting in an average yearly decrease of 2.1% (95% CI 1.5% to 2.7%) after multivariate analysis. We recorded 15 966 OUD-related hospitalisations out of 20 359 574 hospitalisations after ED visits (78.4/100 000 hospitalisations) with an increase from 74.0/100 000 hospitalisations in 2010 to 81.4/100 000 hospitalisations in 2018. The analysis of related diagnoses demonstrated mostly polydrug abuse in this population.ConclusionsWhile the proportion of OUD visits decreased in the time frame, the hospitalisation proportion increased. The implementation of a nationwide surveillance system for OUD in France using ED visits would provide prompt detection of changes over time.

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Background There is a high risk in transitions of care due to lack of information. There are different strategies to improve quality in patient care and security, as an essential part of it. Patients aged > 65 are a group of high risk with great co-morbidity and polimedication. Medication reconciliation is becaming standard of care in most hospitals. Purpose To determine the feasibility of a reconciliation programme in the Emergency department (ED) at patient discharge. Materials and methods Pilot study carried out over three months in a third level hospital (>1,000 beds). Patients were located in the Observation ward of ED, aged ≥65, suffering from ≥3 diseases and being treated with at least 5 drugs. Before discharge, the Emergency Pharmacist (EP) is asked on electronic request to adjust drug therapy with the most accurate list of out-patient medication. Results The reconciliation process was undertaken in 35 patients: 24 women, 11 men. Mean age 80 years (range 65–92). Average comorbility 6.3 diseases, with renal or hepatic impairment in 11 patients. Drugs reconciliated: 444. Average 12.7 per patient. Discrepancies between ED information at admission and EP review before discharge: 170 (4.9 per patient), 76 omissions (2.2 per patient). 45 drug-related problems with medication taken prior to admission: 14 concerning efficacy and 31, security. Resolved before discharge, 55.6%. 31% remained unresolved waiting for primary care or hospital admission reassessment. A total of 12 patients received written and verbal drug information at discharge, as a result of the reconciliation process. Eight patients out of 12 were provided with a drug therapy report. Updated and accurate drug information electronic record remained available in the medical history after ED discharge. Conclusions Reconciliation at ED discharge is feasible in the Observation ward and may improve drug therapy, preventing adverse drug events at transition points. No conflict of interest.