Comparing the predictive capability of self-report and medically-verified non-fatal overdose in adults released from prison: A prospective data linkage study

Claire Keen; Stuart A Kinner; Rohan Borschmann; Jesse T Young

doi:10.1016/j.drugalcdep.2019.107742

Comparing the predictive capability of self-report and medically-verified non-fatal overdose in adults released from prison: A prospective data linkage study

Drug Alcohol Depend. 2020 Jan 1:206:107742. doi: 10.1016/j.drugalcdep.2019.107742. Epub 2019 Nov 14.

Authors

Claire Keen¹, Stuart A Kinner², Rohan Borschmann³, Jesse T Young⁴

Affiliations

¹ Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia. Electronic address: Claire.keen@unimelb.edu.au.
² Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Mater Research Institute-UQ, University of Queensland, Brisbane, Queensland, Australia; Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
³ Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia; National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.

PMID: 31778949
DOI: 10.1016/j.drugalcdep.2019.107742

Abstract

Background: Self-reported non-fatal overdose (NFOD) is a predictor of future overdose and is often used to target overdose prevention for people released from prison. However, the level of agreement between self-reported and medically-verified NFOD history remains unknown. This study aimed to determine the agreement between, and predictive value of, self-reported and medically-verified history of NFOD in people recently released from prison.

Methods: Pre-release baseline survey data from 1307 adults in prison surveyed from 2008 to 2010 in Queensland, Australia were linked to ambulance, emergency department, and hospital records. We compared the agreement of self-reported NFOD history in the baseline survey and medically-verified NFOD ascertained through linked medical data. Unadjusted and adjusted regression models were used to determine the association between self-reported and medically verified NFOD history and medically-verified NFOD after release from prison.

Results: 224 (19 %) participants self-reported NFOD history only, 75 (5 %) had medically-verified NFOD history only, and 56 (4 %) both self-reported and had medically-verified NFOD history. Compared to those with no NFOD history, those who self-reported and had a medical history of NFOD (adjusted hazard ratio (AHR) 6.1, 95 %CI 3.1-11.9), those with a medical history only (AHR 3.4, 95 %CI 1.7-7.0), and those who self-reported only (AHR 1.8, 95 %CI 1.0-3.5) were at increased risk of medically-verified NFOD after release from prison.

Conclusions: Relying on self-report of NFOD is likely to miss people at increased risk of future NFOD, many of whom could be identified through medical records. Wherever possible, data related to NFOD should be triangulated from multiple sources.

Keywords: Cohort studies; Drug overdose; Linked data; Prisons; Self-report.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Drug Overdose / diagnosis*
Drug Overdose / epidemiology*
Emergency Service, Hospital / standards
Female
Follow-Up Studies
Humans
Information Storage and Retrieval / methods
Information Storage and Retrieval / standards*
Male
Medical Records / standards*
Middle Aged
Prisoners*
Prisons
Prospective Studies
Queensland / epidemiology
Risk Factors
Self Report / standards*
Young Adult