Community Opioid Dispensing after Injury (CODI): Cohort characteristics and opioid dispensing patterns.

BACKGROUND: Despite a focus of opioid-related research internationally, there is limited understanding of long-term opioid use in adults following injury. We analysed data from the 'Community Opioid Dispensing after Injury' data linkage study. AIMS: This paper aims to describe the baseline characteristics of the injured cohort and report opioid dispensing patterns following injury-related hospitalisations. METHODS: Retrospective cohort study of adults hospitalised after injury (ICD-10AM: S00-S99, T00-T75) in Queensland, Australia between 1 January 2014 and 31 December 2015, prior to implementation of opioid stewardship programs. Data were person-linked between hospitalisation, community opioid dispensing and mortality collections. Data were extracted for 90-days prior to the index hospital admission, to establish opiate naivety, to 720 days after discharge. Median daily oral morphine equivalents (i.e., dose) were averaged for each 30-day interval. Cumulative duration of dispensing and dose were compared by demographic and clinical characteristics, stratified by drug dependency status. RESULTS: Of the 129,684 injured adults, 61.3 % had no opioids dispensed in the 2-year follow-up period. Adults having any opioids dispensed in the community (38.7 %) were more likely older, female, to have fracture injuries and injuries with a higher severity, compared to those with no opioids dispensed. Longer durations and higher doses of opioids were seen for those with pre-injury opioid use, more hospital readmissions and repeat surgeries, as well as those who died in the 2-year follow-up period. Median dispensing duration was 24-days with a median daily end dose of 13 oral morphine equivalents. If dispensing occurred prior to the injury, duration increased 10-fold and oral morphine equivalents doubled. Adults with a documented dependency prior to, or after, the injury had significantly longer durations of use and higher doses than the rest of the cohort receiving opioids. Approximately 7 % of the total cohort continued to be dispensed opioids at 2-years post injury. CONCLUSION: This is a novel population-level profile of opioid dispensing patterns following injury-related hospitalisation, described for the time period prior to the implementation of opioid stewardship programs and regulatory changes in Queensland. Detailed understanding of this pre-implementation period is critical for evaluating the impact of these changes moving forward.

Electric personal MObility DEvices Surveillance (E-MODES) study: Injury presentations to emergency departments in Brisbane, Queensland.

OBJECTIVE: The rapid increase in e-mobility globally, including in Australia, has seen a concurrent increase in e-mobility-related injuries. Monitoring and understanding the patterns of injuries is essential to preserving community safety and making responsive and effective policy decisions regarding their safe use. METHODS: This study reports on the first phase of the E-MODES study, a proactive injury surveillance initiative to examine the incidence and nature of injuries, their circumstances, contributing factors, and treatment, presenting to three hospital emergency departments (EDs) in Brisbane, the first Australian city to trial shared e-scooters. RESULTS: During the 31-month study period, there were 1048 ED presentations related to e-mobility, the vast majority (90.8%) involving e-scooters, with males accounting for 64.3% of cases, the most common age group being 25-34 years, and weekends being the most common period of the week for presentations. The most common injury was fractures (37%), and the upper extremities and head/face were the most commonly injured body regions. CONCLUSION: Contributing risk factors of alcohol use, not wearing a helmet, and speeding, were prevalent, though poorly recorded and only alcohol use proportions varied by age and gender, with males being more likely than females to have alcohol use reported. Recommendations to support e-mobility-related injury surveillance and safety outcomes include improved data standardisation and sharing.