Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
PLoS One. 2024 Aug 27;19(8):e0308482. doi: 10.1371/journal.pone.0308482. eCollection 2024.
Between June and November 2017, four supervised consumption sites (SCS) began operating in Montreal, Quebec. Earlier studies on SCS focused on examining their effects on blood-borne viral infections and overdose mortality. Our objective was to examine the effect of Montreal's SCS on the incidence, health service use and outcomes of injection-related infections (IRI) in people who inject drugs.
We used Quebec's provincial administrative health data to identify people who inject drugs in Montreal and calculated the incidence of IRI in this population between December 2014 and December 2019. We conducted a retrospective, population-based interrupted time series to estimate the effect of Montreal's four SCS on the monthly incidence rates of IRI-related hospitalizations, emergency department (ED) visits, physician visits, and mortality. We also examined the effects of SCS on average length of IRI-related hospitalizations and incidence of hospitalizations involving surgery.
The average age of Montreal's people who inject drugs was 41.84 years, and 66.41% were male. After the implementation of SCS, there was a positive level change in the incidence of hospitalizations (0.97; 95% confidence interval [CI]: 0.26, 1.68) for IRI. There was also a significant post-intervention decline in hospitalization trends (-0.05; 95% CI: -0.08, -0.02), with modest trend changes in ED visits (-0.02; 95% CI: -0.05, 0.02). However, post-intervention changes in level (0.72; 95% CI: -3.85, 5.29) and trend (0.06; 95% CI: -0.23, 0.34) for physician visits remained limited. SCS had no effect on the average length of hospitalizations, but there was a decreasing post-intervention trend in hospitalizations involving surgery (-0.03; 95% CI: -0.06, 0.00).
Following the opening of the SCS, there was a moderate decline in the rate of hospitalizations to treat IRI, but the impact of the sites on the rate of physician visits remained limited. These findings suggest that SCS may mitigate the incidence of more serious and complicated IRI over time.
2017 年 6 月至 11 月期间，魁北克省蒙特利尔市开设了四个监督性使用场所（SCS）。早期关于 SCS 的研究侧重于检查它们对血源性病毒感染和过量死亡率的影响。我们的目的是研究蒙特利尔 SCS 对注射相关感染（IRI）在注射毒品者中的发病率、卫生服务使用和结果的影响。
我们使用魁北克省的省级行政卫生数据来确定蒙特利尔的注射毒品者，并计算了 2014 年 12 月至 2019 年期间该人群中 IRI 的发病率。我们进行了回顾性、基于人群的中断时间序列分析，以估计蒙特利尔的四个 SCS 对与 IRI 相关的住院、急诊（ED）就诊、医生就诊和死亡率的每月发病率的影响。我们还检查了 SCS 对 IRI 相关住院平均长度和涉及手术的住院发生率的影响。
蒙特利尔注射毒品者的平均年龄为 41.84 岁，其中 66.41%为男性。在 SCS 实施后，IRI 的住院率出现了积极的水平变化（0.97；95%置信区间 [CI]：0.26，1.68）。住院趋势也呈现出显著的干预后下降（-0.05；95%CI：-0.08，-0.02），急诊就诊趋势略有变化（-0.02；95%CI：-0.05，0.02）。然而，干预后的医生就诊水平（0.72；95%CI：-3.85，5.29）和趋势（0.06；95%CI：-0.23，0.34）变化仍有限。SCS 对平均住院时间没有影响，但涉及手术的住院时间呈下降趋势（-0.03；95%CI：-0.06，0.00）。
SCS 开设后，IRI 住院率适度下降，但 SCS 对医生就诊率的影响仍有限。这些发现表明，SCS 可能随着时间的推移减轻更严重和复杂的 IRI 的发生率。
