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Open Access research with a European policy impact...

The Strathprints institutional repository is a digital archive of University of Strathclyde's Open Access research outputs. Strathprints provides access to thousands of Open Access research papers by Strathclyde researchers, including by researchers from the European Policies Research Centre (EPRC).

EPRC is a leading institute in Europe for comparative research on public policy, with a particular focus on regional development policies. Spanning 30 European countries, EPRC research programmes have a strong emphasis on applied research and knowledge exchange, including the provision of policy advice to EU institutions and national and sub-national government authorities throughout Europe.

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High drug-related death rate soon after hospital discharge for drug-treatment clients in Scotland

Merrall, E. and Bird, S. and Hutchinson, S. (2011) High drug-related death rate soon after hospital discharge for drug-treatment clients in Scotland. Journal of Epidemiology and Community Health, 65 (Supple). A133-A133. ISSN 0143-005X

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Abstract

Leading causes of death for drug-treatment clients across Scotland, 1996–2006, were drug-related (1383 DRDs) and non-drug-related suicides (269). We investigate DRD-risk by time since most recent hospital stay. Drug-treatment records were linked to national registers of deaths, hepatitis C virus (HCV) diagnoses, and hospital/psychiatric episodes. We calculated DRD-rates (and suicide-rates): during hospitalisation, within 28 days, 29–90 days, 91 days -1 year, >1 year since discharge from most recent hospital stay vs never admitted. Proportional hazards analysis adjusted for demographic and other time-specific influences on DRD-risk. The cohort comprised 69 457 individuals, 350 317 person-years (pys) and 90 314 hospital-stays. DRD-rate per 1000 person-years (pys) was: 87 (95% CI 72 to 103) during hospitalisation, 21 (18 to 25) within 28 days, 12 (10 to 15) during 29–90 days and 8.5 (7.5 to 9.5) during 91 days to 1 year after discharge vs 4.2 (3.7 to 4.7) when >1 year after most recent hospitalisation and 1.9 (1.7–2.1) for those never admitted. Adjusted HRs by time since hospital-discharge (vs never admitted) were: 10 (95% CI 8 to 12) within 28 days, 5.6 (4.6 to 6.8) during 29–90 days, and 4.0 (3.5 to 4.7) vs 2.3 (2.0 to 2.7) when >1 year after most recent hospital stay. Alcohol misuse increased HR (1.5, 1.3 to 1.7) and female, never injector, and no HCV diagnosis decreased it: 0.56 (0.49 to 0.64), 0.62 (0.52 to 0.73), 0.74 (0.65 to 0.85). Hospital discharge marks high DRD-risk periods. Doctors should consider prescribing Naloxone when discharging patients with opiate-dependency, and emailing discharge summary to alert the patients' general practitioner or drug treatment agency.