Preventable suicides involving medicines before the covid-19 pandemic: a systematic case series of coroners reports in England and Wales (pre-print) (preprint)

BackgroundOver 5000 suicides are registered in England and Wales each year. Coroners Prevention of Future Deaths reports (PFDs) share concerns to promote actions to reduce the risks of similar deaths. AimsTo systematically review coroners PFDs involving suicides in which a medicine caused or contributed to the death, to identify lessons for suicide prevention. Methods3037 PFDs were screened for eligibility between July 2013 and December 2019. Following data extraction, descriptive statistics and content analysis were performed to assess coroners concerns, the recipients, and the response rates to coroners. ResultsThere were 734 suicide-related PFDs, with 100 reporting a medicine. Opioids (40%) were the most common class involved in suicide-related PFDs, followed by antidepressants (30%). There was wide geographical variation in the writing of PFDs; coroners in Manchester wrote the most (18%). Coroners expressed 237 concerns; the most common were procedural inadequacies (14%, n=32), inadequate documentation and communication (10%, n=22), and inappropriate prescription access (9%, n=21). 203 recipients received these PFDs, most being sent to NHS trusts (31%), clinical commissioning groups (10%), and general practices (10%), of which only 58% responded to the coroner. We created the Preventable Deaths Tracker (https://preventabledeathstracker.net/) to increase dissemination and analysis of coroners PFDs. ConclusionsConcerns raised by coroners in suicide-related PFDs involving medicines highlight essential gaps in care that require actions from the Government, health services, and prescribers. To aid suicide prevention, PFDs should be disseminated nationally, and responses should be enforced so that actions are taken to prevent suicides. Study protocol registrationhttps://doi.org/10.17605/OSF.IO/EXJK3

Open science policies of medical and health sciences journals before and during the COVID-19 pandemic: a repeat cross-sectional study (preprint)

Cross-disciplinary openness and transparency of research plays an important role in scientific progress. We evaluated open-science related policies of 19 high ranking health and medical journals before (February 2020) and during (May 2021) the COVID-19 pandemic. The Transparency and Openness Promotion (TOP) guideline and the International Committee of Medical Journal Editors (ICMJE) requirements for disclosing conflicts of interest (COIs) were used to audit journal policies. TOP scores slightly improved during the COVID-19 pandemic, from a median of 5 (IQR: 2-12.5) out of a possible 24 points in February 2020 to 7 (IQR: 4-12) in May 2021. Most journals fulfilled all ICMJE provisions for reporting COIs before (84%; n=16) and during (95%; n=18) the COVID-19 pandemic. The COVID-19 pandemic has highlighted the importance of practising open science, however adherence to open science standards in audited policies was low overall, which may reduce progress in health and medical research.

Preventable deaths from SARS-CoV-2 in England and Wales: a systematic analysis of coroners case reports from the COVID-19 pandemic (preprint)

As of June 2021, 12% of global deaths attributed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have occurred in England and Wales. Examining Coroners Prevention of Future Deaths reports (PFDs) between March 2020 and 28 June 2021 in England and Wales, we found 23 cases (4.5% of PFDs) involving SARS-CoV-2, with 52% (n=12) of deaths indirectly- and 48% directly-related. There was geographical variation with most (39%) PFDs written by coroners in the North-West of England. Fifty-six concerns were raised by coroners with problems in communication being the most (30%) repeated concern, followed by a failure to follow protocols (23%). Organisations in the National Health Services (NHS) received the most PFDs (51%), followed by the government (26%). Policymakers should consider an intermediate step prior to PFDs to ensure lessons from the COVID-19 pandemic are rapidly identified. In the meantime, PFDs should be used to prevent future deaths.