Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015

Dufault, Kenneth; Swenson, David; Lakevicius, Paul; Metcalf, Erin; Chan, Benjamin P.

doi:10.1177/0033354917707934

Cited by 13 publications

(18 citation statements)

References 8 publications

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“…This contrasts with data in USA, where the proportion of OUD-related ED visits observed in 2010 was 63/100 000 18 with an increase between 2011 and 2015. 17 However, our data are consistent with those previously observed in France showing relative stability between 2004 and 2017 in opioid consumption. The discrepancy between the increase in the raw numbers of OUD-related ED visits and the decrease in the proportion of visits can be explained by the increase in total ED activity in France, 33 a phenomenon seen worldwide.…”

Section: Discussion Key Resultssupporting

confidence: 93%

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Epidemiological study of opioid use disorder in French emergency departments, 2010–2018 from OSCOUR database

et al. 2020

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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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Section: Discussion Key Resultssupporting

confidence: 93%

“… 14–16 Importantly, they also have been used specifically for OUD in the USA to monitor trends at the state and national levels. 17 18 ED data allow for the observation of a greater variety of patients than those who are hospitalised, mostly catching less serious patients.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological study of opioid use disorder in French emergency departments, 2010–2018 from OSCOUR database

et al. 2020

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“…In a nested case–control study in New York, the odds of death due to prescription drug overdose were 4.9 times higher for those with two ED visits, 16.6 times higher for those with three ED visits, and 48.2 times higher for those with four or more visits relative to one ED visit or less in the year preceding death 16. Thus, the ED is both a critical and timely place for intervention and the reason for the ED visit itself (ie, overdose) can be used as an opportunity to identify patients at highest risk of fatal drug overdose and deliver interventions 18…”

Section: Introductionmentioning

confidence: 99%

Randomised clinical trial of an emergency department-based peer recovery support intervention to increase treatment uptake and reduce recurrent overdose among individuals at high risk for opioid overdose: study protocol for the navigator trial

et al. 2019

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IntroductionEffective approaches to increase engagement in treatment for opioid use disorder (OUD) and reduce the risk of recurrent overdose and death following emergency department (ED) presentation for opioid overdose remain unknown. As such, we aim to compare the effectiveness of behavioural interventions delivered in the ED by certified peer recovery support specialists relative to those delivered by licensed clinical social workers (LCSWs) in promoting OUD treatment uptake and reducing recurrent ED visits for opioid overdose.Methods and analysisAdult ED patients who are at high risk for opioid overdose (ie, are being treated for an opioid overdose or identified by the treating physician as having OUD) (n=650) will be recruited from two EDs in a single healthcare system in Providence, Rhode Island into a two-arm randomised trial with 18 months of follow-up postrandomisation. Eligible participants will be randomly assigned (1:1) in the ED to receive a behavioural intervention from a certified peer recovery support specialist or a behavioural intervention from an LCSW. The primary outcomes are engagement in formal OUD treatment within 30 days of the initial ED visit and recurrent ED visits for opioid overdose within 18 months of the initial ED visit, as measured through statewide administrative records.Ethics and disseminationThis protocol was approved by the Rhode Island Hospital institutional review board (Approval Number: 212418). Data will be presented at national and international conferences and published in peer-reviewed journals.Trial registration numberNCT03684681.

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“…ISDH is launching a pilot project to encourage local partners to start a conversation about overdose response capabilities and planning efforts in their community. Other states have published articles about drug overdose syndromic surveillance (SyS) data being used to inform local public health action, however, the local overdose response activity details were vague 2,3 . With the opioid crisis continuing to spiral out of control in the United States, it is imperative to work together as local, state, and national partners to find potential solutions to this crisis.…”

Section: Introductionmentioning

confidence: 99%

Using Drug Overdose Syndromic Surveillance Data to Impact Local Public Health Action

Billman

Dotson

2018

OJPHI

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Objective: The overall objective of this session is to discuss opportunities to use drug overdose syndromic surveillance (SyS) data to encourage action among local public health partners.After this roundtable discussion, participants will be able to:-Identify opportunities to promote use of drug overdose SyS data to their health partners.-Plan for potential drug overdose public health interventions.-Develop relationships with roundtable attendees to continue the conversation and sharing of ideas about use of drug overdose SyS data.Introduction: Since 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana and the gap continues to widen1. As the opioid crisis rages on in the United States the federal government is providing funding opportunities to states, but it often takes years for best practices to be developed, shared, and published.Indiana State Department of Health (ISDH) has developed a standard process for monitoring and alerting local health partners of increases in drug overdoses captured in Indiana’s syndromic surveillance system (ESSENCE). ISDH is launching a pilot project to encourage local partners to start a conversation about overdose response capabilities and planning efforts in their community. Other states have published articles about drug overdose syndromic surveillance (SyS) data being used to inform local public health action, however, the local overdose response activity details were vague 2,3. With the opioid crisis continuing to spiral out of control in the United States, it is imperative to work together as local, state, and national partners to find potential solutions to this crisis.Description: Overdose Surveillance Epidemiologists from Indiana will lead a roundtable discussion about potential uses of syndromic surveillance (SyS) overdose data to kick-start overdose response and prevention efforts at the local and state level. Discussion will begin by the moderators highlighting best practices for overdose response using SyS data and some Indiana specific initiatives. Topics for the roundtable discussion will include:-Drug overdose query development and enhancement.-Dissemination strategies for SyS alerts of suspected drug overdoses.-Best practices for reporting SyS overdose data to partners and/or public.-Public health intervention and prevention strategies using real-time hospital emergency department (ED) data.-Review of national or regional work groups focused on drug overdose SyS.How the Moderator Intends to Engage the Audience in Discussions on the Topic: The moderators, Mandy Billman and Kayley Dotson, are Overdose Surveillance Epidemiologists for Indiana, and they intend to kick off the discussion by presenting a short handout that will highlight Indiana’s efforts to engage local health partners with near real-time drug overdose data, (i.e. monitoring and alerting local partners, developing a resource tool kit, sharing drug overdose queries, etc.). Mandy and Kayley will also develop a series of questions to actively engage participants in the discussion of bridging the gap from data to action using overdose surveillance data.

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Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015

Abstract: Opioid-related ED encounters in New Hampshire increased substantially from 2011 to 2015. Data from New Hampshire's ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic.

Cited by 13 publications

References 8 publications

Epidemiological study of opioid use disorder in French emergency departments, 2010–2018 from OSCOUR database

Epidemiological study of opioid use disorder in French emergency departments, 2010–2018 from OSCOUR database

Randomised clinical trial of an emergency department-based peer recovery support intervention to increase treatment uptake and reduce recurrent overdose among individuals at high risk for opioid overdose: study protocol for the navigator trial

Using Drug Overdose Syndromic Surveillance Data to Impact Local Public Health Action

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