Recording of clinical information in a Scotland-wide drug deaths study.
The aim of this study was to analyse the nature and extent of data extracted from case files of deceased individuals in contact with services 6 months prior to drug deaths in Scotland during 2003. A cross-sectional descriptive analysis of 317 case notes of 237 individuals who had drug-related deaths was undertaken, using a data linkage process. All contacts made with services in the 6 months prior to death were identified. Information on clinical and social circumstances obtained from social care, specialist drug treatment, mental health, non-statutory services, the Scottish Prison Service and Criminal Records Office was collated. More than 70% (n = 237) were seen 6 months prior to their drug death. Sociodemographic details were reported much more frequently than medical problems, for example, ethnicity (49%), living accommodation (66%), education and income (52%) and dependent children (73%). Medical and psychiatric history was recorded in only 12%, blood-borne viral status in 17% and life events in 26%. This paucity of information was a feature of treatment plans and progress recorded. The 237 drug deaths were not a population unknown to services. Highly relevant data were missing. Improved training to promote in-depth recording and effective monitoring may result in better understanding and reduction of drug deaths.
Centre for Addiction Research and Education Scotland (CARES), Division of Molecular and Translational Medicine, College of Medicine, Nursing and Dentistry, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, UK. a.baldacchino@dundee.ac.uk
A
A
Baldacchino
I B
IB
Crome
D
D
Zador
S
S
McGarrol
A
A
Taylor
S
S
Hutchison
T
T
Fahey
M
M
Hickman
B
B
Kidd
D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000401:mortality; D006801:Humans; D008498:Medical Record Linkage; D008499:Medical Records / Q000706:statistics & numerical data*; D011996:Records / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000401:mortality*