Evaluating Montréal's harm reduction interventions for people who inject drugs: protocol for observational study and cost-effectiveness analysis.
epidemiology
health economics
health policy
protocols & guidelines
public health
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
26 10 2021
26 10 2021
Historique:
entrez:
27
10
2021
pubmed:
28
10
2021
medline:
4
11
2021
Statut:
epublish
Résumé
The main harm reduction interventions for people who inject drugs (PWID) are supervised injection facilities, needle and syringe programmes and opioid agonist treatment. Current evidence supporting their implementation and operation underestimates their usefulness by excluding skin, soft tissue and vascular infections (SSTVIs) and anoxic/toxicity-related brain injury from cost-effectiveness analyses (CEA). Our goal is to conduct a comprehensive CEA of harm reduction interventions in a setting with a large, dispersed, heterogeneous population of PWID, and include prevention of SSTVIs and anoxic/toxicity-related brain injury as measures of benefit in addition to HIV, hepatitis C and overdose morbidity and mortalities averted. This protocol describes how we will develop an open, retrospective cohort of adult PWID living in Québec between 1 January 2009 and 31 December 2020 using administrative health record data. By complementing this data with non-linkable paramedic dispatch records, regional monthly needle and syringe dispensation counts and repeated cross-sectional biobehavioural surveys, we will estimate the hazards of occurrence and the impact of Montréal's harm reduction interventions on the incidence of drug-use-related injuries, infections and deaths. We will synthesise results from our empirical analyses with published evidence to simulate infections and injuries in a hypothetical population of PWID in Montréal under different intervention scenarios including current levels of use and scale-up, and assess the cost-effectiveness of each intervention from the public healthcare payer's perspective. This study was approved by McGill University's Institutional Review Board (Study Number: A08-E53-19B). We will work with community partners to disseminate results to the public and scientific community via scientific conferences, a publicly accessible report, op-ed articles and open access peer-reviewed journals.
Identifiants
pubmed: 34702731
pii: bmjopen-2021-053191
doi: 10.1136/bmjopen-2021-053191
pmc: PMC8549659
doi:
Substances chimiques
Pharmaceutical Preparations
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e053191Subventions
Organisme : CIHR
ID : 436351
Pays : Canada
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Int J Drug Policy. 2010 Jan;21(1):70-6
pubmed: 19423324
Acad Emerg Med. 2007 Jul;14(7):616-23
pubmed: 17554010
Ann Intern Med. 2015 Mar 17;162(6):407-19
pubmed: 25775313
Arch Dermatol. 2007 Oct;143(10):1305-9
pubmed: 17938345
Drug Alcohol Depend. 2014 Sep 1;142:174-80
pubmed: 25008106
Clin Infect Dis. 2017 Apr 1;64(7):860-869
pubmed: 28362947
J Med Econ. 2014 Oct;17(10):730-40
pubmed: 25019580
Health Serv Outcomes Res Methodol. 2013 Mar;13(1):39-57
pubmed: 30555270
Drug Alcohol Depend. 2014 Dec 1;145:48-68
pubmed: 25456324
Emerg Infect Dis. 2007 Oct;13(10):1510-1
pubmed: 18257999
Int J Epidemiol. 2014 Feb;43(1):235-48
pubmed: 24374889
Stat Med. 2016 Mar 30;35(7):1001-16
pubmed: 26932124
AIDS. 2008 Oct 1;22(15):1979-91
pubmed: 18784461
Circulation. 2016 Feb 9;133(6):601-9
pubmed: 26858290
Value Health. 2009 Mar;12 Suppl 1:S10-5
pubmed: 19250125
AIDS Behav. 2016 Jan;20(1):22-8
pubmed: 26336945
J Eval Clin Pract. 2018 Apr;24(2):447-453
pubmed: 29356225
Health Econ. 2013 Apr;22(4):486-500
pubmed: 22447531
Can Pharm J (Ott). 2020 Sep 21;153(6):352-356
pubmed: 33282025
Pharmacoeconomics. 2016 Jul;34(7):665-72
pubmed: 26961779
Addiction. 2012 Jul;107(7):1318-27
pubmed: 22248184
Clin Infect Dis. 2007 Nov 1;45(9):1200-3
pubmed: 17918083
J Health Econ. 2010 Jan;29(1):110-23
pubmed: 20015560
Virulence. 2016;7(2):201-8
pubmed: 26305706
Ann Intern Med. 2018 Sep 4;169(5):329-332
pubmed: 30083766
Stat Med. 2016 Feb 20;35(4):553-65
pubmed: 26542758
Int J Drug Policy. 2017 Sep;47:169-176
pubmed: 28578865
Chron Respir Dis. 2013 May;10(2):85-94
pubmed: 23620439
PLoS One. 2013 Jun 13;8(6):e65761
pubmed: 23785448
Drug Alcohol Depend. 2017 Feb 01;171:39-49
pubmed: 28013096
CMAJ. 2008 Nov 18;179(11):1143-51
pubmed: 19015565
J Health Serv Res Policy. 2004 Oct;9(4):197-204
pubmed: 15509405
PLoS One. 2013;8(2):e54496
pubmed: 23405084
Int J Drug Policy. 2012 Jul;23(4):257-60
pubmed: 22464795
Biometrics. 1995 Jun;51(2):524-32
pubmed: 7662841
Acad Pediatr. 2013 Nov-Dec;13(6 Suppl):S38-44
pubmed: 24268083
Epidemiol Infect. 2010 Oct;138(10):1510-8
pubmed: 20163753
Am J Prev Med. 2018 Jan;54(1):e37-e39
pubmed: 29132953
Lancet. 2011 Apr 23;377(9775):1429-37
pubmed: 21497898
Mayo Clin Proc. 2014 Apr;89(4):462-71
pubmed: 24629443
J Theor Biol. 2019 Nov 21;481:194-201
pubmed: 30452959
Harm Reduct J. 2010 May 25;7:11
pubmed: 20500870
Harm Reduct J. 2014 May 22;11:16
pubmed: 24885902
Value Health. 2010 Jun-Jul;13(4):358-67
pubmed: 20659272
Stat Methods Med Res. 2019 Jan;28(1):248-262
pubmed: 28882094
J Health Econ. 2017 Sep;55:76-94
pubmed: 28728807
Addiction. 2010 Apr;105(4):676-83
pubmed: 20148794
Lancet. 2016 Jul 16;388(10041):268-74
pubmed: 27207746
Int J Epidemiol. 2018 Dec 1;47(6):2082-2093
pubmed: 29982445
Value Health. 2003 Jan-Feb;6(1):9-17
pubmed: 12535234
Int J Drug Policy. 2018 May;55:31-39
pubmed: 29482150
Stat Med. 2010 Oct 15;29(23):2453-68
pubmed: 20645282
Infect Dis Model. 2018 Sep 21;3:160-170
pubmed: 30839936
Lancet. 2010 Mar 20;375(9719):1014-28
pubmed: 20189638
Nephrol Dial Transplant. 2017 Apr 1;32(suppl_2):ii84-ii90
pubmed: 28201767
Harm Reduct J. 2018 May 8;15(1):23
pubmed: 29739408
QJM. 2006 Nov;99(11):737-42
pubmed: 16956922
Pharmacoeconomics. 2006;24(4):355-71
pubmed: 16605282
Med Decis Making. 2012 Sep-Oct;32(5):678-89
pubmed: 22990083
Med Care. 2017 Jan;55(1):50-56
pubmed: 27547950
Stat Med. 2009 Nov 30;28(27):3437-53
pubmed: 19708037
Stat Med. 2002 Jun 30;21(12):1689-709
pubmed: 12111906
Forensic Sci Int. 1999 May 31;102(1):51-9
pubmed: 10423852
Value Health. 2013 Mar-Apr;16(2):e1-5
pubmed: 23538200
Hepatology. 2008 Aug;48(2):418-31
pubmed: 18563841
Int J Drug Policy. 2012 Jan;23(1):37-44
pubmed: 21689917
Med Decis Making. 2012 Sep-Oct;32(5):733-43
pubmed: 22990088