Emergency Department Visits in a Cohort of Persons with Substance Use: Incorporating the Role of Social Networks

Sacamano, Paul; Krawczyk, Noa; Latkin, Carl A.

doi:10.1080/10826084.2018.1461225

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…As a component of social support, informational support has been linked to improve emergency healthcare utilization 28‐30 and progress through the HCV care continuum among people who use drugs 29 . Similarly, having specific network members, such as supportive family members, has been linked to different stages of the HCV care continuum, including HCV treatment initiation and achievement of HCV cure 39,42,43 .…”

Section: Discussionmentioning

confidence: 99%

“…Based on social network theory, through group or individual relationships, network members, or peers, provide critical functional social support to one another. Among different levels of support, informational support consists of sharing knowledge, offering suggestions or giving advice, and has been previously linked to healthcare utilization within populations of PWID 27‐30 . Modelling data on HCV transmission and elimination support the importance of considering PWID social network factors in intervention development and its potential impact on reducing overall HCV incidence 31 .…”

Section: Introductionmentioning

confidence: 99%

“…Among different levels of support, informational support consists of sharing knowledge, offering suggestions or giving advice, and has been previously linked to healthcare utilization within populations of PWID. [27][28][29][30] Modelling data on HCV transmission and elimination support the importance of considering PWID social network factors in intervention development and its potential impact on reducing overall HCV incidence. 31 However, to date, there are limited empiric data on the feasibility of network-based recruitment of PWID for HCV treatment.…”

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confidence: 99%

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Network‐based recruitment of people who inject drugs for hepatitis C testing and linkage to care

Falade‐Nwulia

Ward

McCormick

et al. 2020

Journal of Viral Hepatitis

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Although oral direct‐acting agent (DAA) therapies have the potential to reduce the burden of hepatitis C virus (HCV) infection, treatment uptake remains low, particularly among people who inject drugs (PWID). This study examined the feasibility of an innovative peer‐based recruitment strategy to engage PWID in HCV testing and treatment. We interviewed an initial set of HCV antibody‐positive PWID as ‘primary indexes’ to gather demographic, drug use, health information and drug network characteristics. Primary indexes were then briefly educated on HCV and its treatment and encouraged to recruit their injection drug ‘network members’ for HCV testing and linkage to care. Eligible network members were enrolled as ‘secondary indexes’ and completed the same index study procedures. In sum, 17 of 36 primary indexes initiated the recruitment of 64 network members who were HCV antibody positive and eligible to become indexes. In multivariable analysis, successful recruitment of at least one network member was positively associated with prior HCV treatment (OR 2.80; CI [1.01, 7.72]), daily or more injection drug use (OR 2.38; CI [1.04, 5.47]), and a higher number of injection drug network members (OR 1.20; CI [1.01, 1.42]). Among the 69 participants with chronic HCV not previously linked to HCV care at enrolment, 91% (n = 63) completed a linkage to HCV care appointment, 45% (n = 31) scheduled an appointment with an HCV provider, and 20% (n = 14) initiated HCV therapy. These findings suggest a potential benefit for peer‐driven, network‐based interventions focused on HCV treatment‐experienced PWID as a mechanism to increase HCV linkage to care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Network‐based recruitment of people who inject drugs for hepatitis C testing and linkage to care

Falade‐Nwulia

Ward

McCormick

et al. 2020

Journal of Viral Hepatitis

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“…Finally, the concept of low threshold was expanded in this study, as a result of our consultations, to include a reduction in expectations and stigma of emergency response providers toward people experiencing homelessness and PSU. This need stems from the extent of stigma experienced by people with these dual issues while seeking help or using emergency services (Alunni-Menichini et al, 2020;Doran et al, 2014;Lang et al, 2013;Sacamano et al, 2018;Wise-Harris et al, 2017).…”

Section: B Low Thresholdmentioning

confidence: 99%

Improving the Response to People Experiencing Homelessness and Psychoactive Substance Use in Montreal: A Systemic and Intersectoral Perspective

Alunni‐Menichini

Bertrand²,

Brousselle³

2023

IJOH

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Introduction. Les personnes en situation d’itinérance qui consomment des substances psychoactives font face à plusieurs barrières à l’accès aux services généraux et ceux qui leur sont dédiés. Cela les mène, entre autres, à interagir fréquemment avec les services d’urgence, que ce soit avec la police, les services paramédicaux et les urgences hospitalières. Pourtant, ces services sont peu adaptés à leurs besoins. Il est donc important d’identifier des pistes de solutions concrètes pour améliorer la réponse d’urgence offerte aux personnes en situation d’itinérance qui consomment des substances psychoactives. Méthodologie. Ce devis évaluatif combine une analyse des besoins avec une évaluation démocratique délibérative. Un processus collaboratif, dont l’utilisation d’une Technique de recherche d’information par l’animation d’un groupe d’experts (TRIAGE) intersectorielle de 32 participants, a été organisé pour prioriser les solutions selon les différentes parties prenantes, soit les prestataires des services d’urgence, les personnes en situation d’itinérance et les autres acteurs qui gravitent autour d’elles (services spécialisés, milieu communautaire, politique et de la recherche). Résultats. Onze solutions ont été priorisées et classées dans quatre catégories : prévention de l’itinérance, approche à bas seuil, continuité des services et gouvernance. Conclusion. Cette étude a permis d’identifier des solutions concrètes et systémiques qui font consensus et qui pourront être implantées dans des contextes similaires au nôtre.

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“…1 Persons with substance use disorders and other comorbid conditions, such as mental illness or homelessness, commonly seek care in ED settings, often as a result of lack of access to regular sources of primary and specialty care. [2][3][4] Frequent hospital and ED use has been linked to greater risk of experiencing both nonfatal and fatal overdoses, 5,6 and both US and international research has found ED utilization to be highest in the months preceding and after overdose. [7][8][9] Given that persons at risk of overdose interact frequently with the ED, intervening at this point of contact could be an effective overdose prevention strategy.…”

Section: Introduction Backgroundmentioning

confidence: 99%

Predictors of Overdose Death Among High-Risk Emergency Department Patients With Substance-Related Encounters: A Data Linkage Cohort Study

Krawczyk

Eisenberg

Schneider

et al. 2020

Annals of Emergency Medicine

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Study objective: Persons with substance use disorders frequently utilize emergency department (ED) services, creating an opportunity for intervention and referral to addiction treatment and harm-reduction services. However, EDs may not have the appropriate tools to distinguish which patients are at greatest risk for negative outcomes. We link hospital ED and medical examiner mortality databases in one state to identify individual-level risk factors associated with overdose death among ED patients with substance-related encounters. Methods: This retrospective cohort study linked Maryland statewide ED hospital claims records for adults with nonfatal overdose or substance use disorder encounters in 2014 to 2015 with medical examiner mortality records in 2015 to 2016. Logistic regression was used to identify factors in hospital records associated with risk of opioid overdose death. Predicted probabilities for overdose death were calculated for hypothetical patients with different combinations of overdose and substance use diagnostic histories. Results: A total of 139,252 patients had substance-related ED encounters in 2014 to 2015. Of these patients, 963 later experienced an opioid overdose death, indicating a case fatality rate of 69.2 per 10,000 patients, 6 times higher than that of patients who used the ED for any cause. Factors most strongly associated with death included having both an opioid and another substance use disorder (adjusted odds ratio 2.88; 95% confidence interval 2.04 to 4.07), having greater than or equal to 3 previous nonfatal overdoses (adjusted odds ratio 2.89; 95% confidence interval 1.54 to 5.43), and having a previous nonfatal overdose involving heroin (adjusted odds ratio 2.24; 95% confidence interval 1.64 to 3.05). Conclusion: These results highlight important differences in overdose risk among patients receiving care in EDs for substance-related conditions. The findings demonstrate the potential utility of incorporating routine data from patient records to assess risk of future negative outcomes and identify primary targets for initiation and linkage to lifesaving care.

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Emergency Department Visits in a Cohort of Persons with Substance Use: Incorporating the Role of Social Networks

Cited by 10 publications

References 17 publications

Network‐based recruitment of people who inject drugs for hepatitis C testing and linkage to care

Network‐based recruitment of people who inject drugs for hepatitis C testing and linkage to care

Improving the Response to People Experiencing Homelessness and Psychoactive Substance Use in Montreal: A Systemic and Intersectoral Perspective

Predictors of Overdose Death Among High-Risk Emergency Department Patients With Substance-Related Encounters: A Data Linkage Cohort Study

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