School of Social Work, Lund University, Lund, Sweden.
Department of Social Work, Malmö University, Malmö, Sweden.
Harm Reduct J. 2024 Oct 18;21(1):186. doi: 10.1186/s12954-024-01101-y.
Understanding the heterogeneity of opioid overdose fatalities is critical to developing effective preventive interventions. This study examines patterns of care contacts among people who subsequently died from opioid overdose. The aim was to identify distinct groups of deceased individuals, based on their contacts with different care agencies in their last year of life.
A retrospective registry study was conducted in Skåne, Southern Sweden. All recorded opioid overdose fatalities during the study period were included, n = 191. Latent class analysis was used to identify patterns of care contacts in the last year of life.
Three distinct classes were identified: "Few care contacts," with limited interaction with any services; "Social service contacts," comprising individuals who predominantly had contacts with the social services and, to a lesser extent, with prison and probation services; and "Numerous care contacts," with extensive contacts with both healthcare and social services. The "few care contacts" class comprises about half of the population. This is an important finding, since this group has not been clearly visible in previous research. The analysis indicates significant gaps in service provision, particularly regarding substance use treatment and mental health support.
Using a person-centred approach, this article offers a novel way of analysing care contacts among people who subsequently died from opioid overdose. The identification of distinct groups, particularly a large group of people with minimal contact with the community care system, highlights the need for more targeted outreach and support work. Developing targeted interventions in emergency and inpatient care settings may provide an opportunity to reach the group with few care contacts.
了解阿片类药物过量致死的异质性对于制定有效的预防干预措施至关重要。本研究考察了随后死于阿片类药物过量的人群的护理接触模式。目的是根据他们在生命的最后一年与不同护理机构的接触情况，确定死者的不同群体。
在瑞典斯科讷进行了一项回顾性登记研究。包括研究期间所有记录的阿片类药物过量致死病例，n=191。使用潜在类别分析来识别生命最后一年的护理接触模式。
确定了三个不同的类别：“护理接触较少”，与任何服务的互动有限；“社会服务接触”，主要包括与社会服务部门接触的个人，以及较少与监狱和缓刑服务部门接触的个人；“大量护理接触”，与医疗保健和社会服务部门都有广泛的接触。“护理接触较少”类别约占人口的一半。这是一个重要的发现，因为这一群体在以前的研究中并不明显。分析表明服务提供存在显著差距，特别是在药物使用治疗和心理健康支持方面。
本文采用以患者为中心的方法，为分析随后死于阿片类药物过量的人群的护理接触提供了一种新方法。不同群体的识别，特别是与社区护理系统接触较少的人群数量较大，突显了需要进行更有针对性的外展和支持工作。在急诊和住院护理环境中制定有针对性的干预措施可能为接触到接触护理较少的群体提供机会。
