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Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis

Joanne E. Brady; Rebecca E. Giglio; Katherine M. Keyes; Charles J. DiMaggio; Guohua Li

Title:
Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis
Author(s):
Brady, Joanne E.
Giglio, Rebecca E.
Keyes, Katherine M.
DiMaggio, Charles J.
Li, Guohua
Date:
Type:
Articles
Department(s):
Epidemiology
Anesthesiology
Volume:
4
Persistent URL:
Book/Journal Title:
Injury Epidemiology
Abstract:
Background: Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data on predictive risk markers are needed. Risk markers are attributes (modifiable and non-modifiable) that are associated with increased probability of an outcome. This review aims to identify risk markers associated with fatal and non-fatal prescription drug overdose by synthesizing findings in the existing peer-reviewed and grey literature. Eligible cohort, case-control, cross-sectional, and case-cohort studies were reviewed and data were extracted for qualitative and quantitative synthesis. Findings: Summary odds ratios (SOR) were estimated from 29 studies for six risk markers: sex, age, race, psychiatric disorders, substance use disorder (SUD), and urban/rural residence. Heterogeneity was assessed and effect estimates were stratified by study characteristics. Of the six risk markers identified, SUD had the strongest association with drug overdose death (SOR = 5.24, 95% confidence interval (CI) = 3.53 - 7.76), followed by psychiatric disorders (SOR = 3.94, 95% CI = 3.09 - 5.01), white race (SOR = 2.28, 95% CI = 1.93 - 2.70), the 35-44 year age group relative to the 25-34 year reference group (SOR = 1.52, 95% CI = 1.31 - 1.76), and male sex (SOR = 1.33, 95% CI = 1.17 - 1.51). Conclusions: This review highlights fatal and non-fatal prescription drug risk markers most frequently assessed in peer-reviewed and grey literature. There is a need to better understand modifiable risk markers and underlying reasons for drug misuse in order to inform interventions that may prevent future drug overdoses.
Subject(s):
Drugs--Overdose
Opioid abuse
Health risk assessment
Epidemiology
Analgesics
Publisher DOI:
https://doi.org/10.1186/s40621-017-0118-7
Item views
8
Metadata:
text | xml
Suggested Citation:
Joanne E. Brady, Rebecca E. Giglio, Katherine M. Keyes, Charles J. DiMaggio, Guohua Li, , Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis, Columbia University Academic Commons, .

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