TY  - JOUR
PY  - 2016//
TI  - Identifying mortality risks in patients with opioid use disorder using brief screening assessment: secondary mental health clinical records analysis
JO  - Drug and alcohol dependence
A1  - Bogdanowicz, Karolina Magda
A1  - Stewart, Robert
A1  - Chang, Chin-Kuo
A1  - Downs, Johnny
A1  - Khondoker, Mizanur
A1  - Shetty, Hitesh
A1  - Strang, John
A1  - Hayes, Richard Derek
SP  - 82
EP  - 88
VL  - 164
IS  - 
N2  - BACKGROUND: Risk assessments are widely used, but their ability to predict outcomes in opioid use disorder (OUD) treatment remains unclear. Therefore, the aim was to investigate if addiction-specific brief risk screening is effective in identifying high mortality risk groups and if subsequent clinical actions following risk assessment impacts on mortality levels. <br><br>METHODS: Opioid use disorder (OUD) patients were identified in the South London and Maudsley Case Register. Deaths were identified through database linkage to the national mortality dataset. Cox and competing-risk regression were used to model associations between brief risk assessment domains and all-cause and overdose mortality in 4488 OUD patients, with up-to 6-year follow-up time where 227 deaths were registered. Data were stratified by admission to general mental health services. <br><br>RESULTS: All-cause mortality was significantly associated with unsafe injecting (HR 1.53, 95% CI 1.10-2.11) and clinically appraised likelihood of accidental overdose (HR 1.48, 95% CI 1.00-2.19). Overdose-mortality was significantly associated with unsafe injecting (SHR 2.52, 95% CI 1.11-5.70) and clinically appraised suicidality (SHR 2.89, 95% CI 1.38-6.03). Suicidality was associated with a twofold increase in mortality risk among OUD patients who were not admitted to mental health services within 2 months of their risk assessment (HR 2.03, 95% CI 1.67-3.24). <br><br>CONCLUSIONS: Diagnosis-specific brief risk screening can identify OUD patient subgroups at increased risk of all-cause and overdose mortality. OUD patients, where suicidality is evident, who are not admitted into services are particularly vulnerable.<br><br>Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2016.04.036
ID  - ref1
ER  -