a National Poisons Information Service (Newcastle Unit), Regional Drug and Therapeutics Centre , Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle , UK.
b National Poisons Information Service (Edinburgh Unit) , Royal Infirmary , Edinburgh , UK.
Clin Toxicol (Phila). 2018 May;56(5):342-347. doi: 10.1080/15563650.2017.1390120. Epub 2017 Oct 26.
Suspected poisoning is a common cause of hospital admission internationally. In the United Kingdom, the National Poisons Information Service (NPIS), a network of four poisons units, provides specialist advice to health professionals on the management of poisoning by telephone and via its online poisoning information and management database, TOXBASE.
To demonstrate the impact of NPIS telephone advice and TOXBASE guidance on poisoning-related referrals to emergency departments (ED) from primary healthcare settings.
A telephone survey of primary healthcare providers calling the NPIS and an online survey of TOXBASE primary care users were conducted to evaluate the effect of these services on poisoning-related ED referrals. Enquirers were asked to indicate whether referral was needed before and after using these information sources.
The number of cases considered by enquirers appropriate for ED referral was reduced from 1178 (58.1%) before to 819 (40.4%) after the provision of telephone advice for 2028 cases (absolute reduction 17.7%, 95% CI 14.6, 20.7%) and from 410 (48.2%) before to 341 (40.1%) after consideration of TOXBASE guidance for 851 cases (absolute reduction 8.1%, 95% CI 3.3, 12.9%). By extrapolating these figures over a full year, it is estimated that these services prevent approximately 41,000 ED referrals annually.
The use of NPIS services significantly reduced ED referrals from primary healthcare services with resulting avoided healthcare costs exceeding the current annual NPIS budget. Further studies are needed to evaluate other potential benefits of accessing NPIS services.
疑似中毒是国际范围内导致住院的常见原因。在英国，国家中毒信息服务（NPIS）是由四个毒物单位组成的网络，通过电话和其在线中毒信息和管理数据库 TOXBASE 为卫生专业人员提供中毒管理方面的专业建议。
展示 NPIS 电话咨询和 TOXBASE 指南对初级保健环境中向急诊部门（ED）转介与中毒相关的病例的影响。
对拨打 NPIS 的初级保健提供者进行电话调查，并对 TOXBASE 初级保健用户进行在线调查，以评估这些服务对中毒相关 ED 转介的影响。询问者被要求在使用这些信息来源之前和之后表明是否需要转介。
在提供了 2028 例病例的电话咨询后，被询问者认为适合 ED 转介的病例数量从 1178 例（58.1%）减少到 819 例（40.4%）（绝对减少 17.7%，95%CI 14.6，20.7%），在考虑了 TOXBASE 指导后，从 410 例（48.2%）减少到 341 例（40.1%）（绝对减少 8.1%，95%CI 3.3，12.9%）。根据这些数字推断，如果全年都使用这些服务，预计每年可防止约 41000 例 ED 转介。
使用 NPIS 服务可显著减少初级保健服务向 ED 的转介，从而避免的医疗保健费用超过了当前 NPIS 的年度预算。需要进一步研究以评估获取 NPIS 服务的其他潜在益处。
