A cohort study examining emergency department visits and hospital admissions among people who use drugs in Ottawa, Canada

Kendall, Claire; Boucher, Lisa M.; Mark, Amy E.; Martin, Alana; Marshall, Zack; Boyd, Rob; Oickle, Pam; Diliso, Nicola; Pineau, Dave; Renaud, Brad; Rose, Tiffany; LeBlanc, Sean; Tyndall, Mark W.; Lee, Olivia M.; Bayoumi, Ahmed M.

doi:10.1186/s12954-017-0143-4

Cited by 65 publications

(53 citation statements)

References 39 publications

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“…Hospital admission was associated with similar factors: regular or recent injecting , diagnosed hepatitis C , diagnosed HIV , low CD4 count among HIV‐positive participants , female sex , homelessness or unstable housing , alcohol use , polydrug use and mental health problems .…”

Section: Resultsmentioning

confidence: 93%

“…). Infections and particularly skin and soft‐tissue infections were common causes of ED and in‐patient episodes in study populations in Canada , Norway and Taiwan . All infections, and particularly pneumonias, were important causes of health‐care utilization in HIV‐positive opiate users .…”

Section: Resultsmentioning

confidence: 97%

“…The proportion of participants who were hospitalized during the past 12 months ranged from 8% to 41% . Studies including relative measures showed frequency of hospital admission two to eight times that of comparison groups not using illicit drugs . Again, studies of people who inject drugs in rural Taiwan and older people who use cannabis in the United States were exceptions, showing similar frequencies of hospital admission to the general population .…”

Section: Resultsmentioning

confidence: 98%

“…The proportion of participants visiting ED in the past 12 months ranged from 10% to 72% . Studies including relative measures showed frequency of ED utilization of three to 10 times that of comparison groups not using illicit drugs . Exceptions were a study in rural Taiwan, showing that people who inject heroin had a similar rate of ED presentation as the general population , and a study of older people who use cannabis in the United States showing similar odds of ED presentation as those who do not use cannabis .…”

Section: Resultsmentioning

confidence: 99%

“…ED presentation was consistently associated with regular or recent injecting , sex work, diagnosed hepatitis C , diagnosed HIV , female sex , homelessness or unstable housing , crack cocaine or stimulant use , alcohol use , polydrug use and mental health problems .…”

Section: Resultsmentioning

confidence: 99%

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Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Lewer

Freer

King³

et al. 2020

Addiction

121

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Aims To summarize evidence on the frequency and predictors of health-care utilization among people who use illicit drugs. Design Systematic search of MEDLINE, EMBASE and PsychINFO for observational studies reporting healthcare utilization published between 1 January 2000 and 3 December 2018. We conducted narrative synthesis and meta-analysis following a registered protocol (identifier: CRD42017076525). Setting and participants People who use heroin, powder cocaine, crack cocaine, methamphetamine, amphetamine, ecstasy/3,4-methylenedioxymethamphetamine (MDMA), cannabis, hallucinogens or novel psychoactive substances; have a diagnosis of 'substance use disorder'; or use drug treatment services. Measurements Primary outcomes were the cumulative incidence (risk) and rate of care episodes in three settings: primary care, hospital admissions (in-patient) and emergency department (ED).Findings Ninety-two studies were included, 84% from North America and Australia. Most studies focused on people using heroin, methamphetamine or crack cocaine, or who had a diagnosis of drug dependence. We were able to conduct a meta-analysis of rates across 25 studies reporting ED episodes and 25 reporting hospital admissions, finding pooled rates of 151 [95% confidence interval (CI) = 114-201] and 41 (95% CI = 30-57) per 100 person-years, respectively; on average 4.8 and 7.1 times more often than the general population. Heterogeneity was very high and was not explained by drugs used, country of study, recruitment setting or demographic characteristics. Predictors of health-care utilization were consistent across studies and included unstable housing, drug injection and mental health problems. Opioid substitution therapy was consistently associated with reduced ED presentation and hospital admission. There was minimal research on health-care utilization by people using ecstasy/MDMA, powder cocaine, hallucinogens or novel psychoactive substances.Conclusions People who use illicit drugs are admitted to emergency department or hospital several times more often than the general population.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Lewer

Freer

King³

et al. 2020

Addiction

121

View full text Add to dashboard Cite

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Association of Methadone Treatment With Substance-Related Hospital Admissions Among a Population in Canada With a History of Criminal Convictions

2019

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Key Points Question Is adherence to methadone associated with a lower risk of hospital admission among individuals with criminal convictions? Findings In this cohort study including 11 401 Canadian individuals, periods during which methadone was dispensed were associated with lower rates of any acute hospital admission. Meaning Adherence to methadone among individuals with criminal convictions may contribute to lower rates of acute hospitalization.

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Clinical ultrasonography in patients who inject drugs (the CUPID protocol): an illustrated case series

et al. 2020

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In 2017, there were ≈47,600 opioid overdose‐related deaths in the United States. US emergency department (ED) visits for suspected opioid overdose increased by 30% between July 2016 and September 2017. 2 The current US opioid epidemic makes it critical for emergency physicians to be aware of common and uncommon infectious and non‐infectious complications of injection drug use. Point‐of‐care ultrasound has become a widely available, non‐invasive diagnostic tool in EDs across the United States and worldwide. The increasing population of injection drug use patients is at risk for serious morbidity and mortality from an array of disease states amenable to ultrasound‐based diagnosis. We propose a protocol for clinical ultrasonography in patients who inject drugs (the CUPID protocol), a focused, 3‐system point‐of‐care ultrasound approach emphasizing cardiovascular, thoracic, and musculoskeletal imaging. The protocol is a screening tool, designed to detect high risk infectious and noninfectious complications of injection drug use.

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A cohort study examining emergency department visits and hospital admissions among people who use drugs in Ottawa, Canada

Cited by 65 publications

References 39 publications

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Association of Methadone Treatment With Substance-Related Hospital Admissions Among a Population in Canada With a History of Criminal Convictions

Clinical ultrasonography in patients who inject drugs (the CUPID protocol): an illustrated case series

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