There is a drug-related death crisis in Scotland. This study aims to collaborate with Public Health Scotland in order to assess the feasibility of introducing a surveillance system to the Emergency Department to highlight illicit drug-related attendances. This will utilise both clinical data and toxiclogical analysis of anonymised samples. The data will inform of prevalence, trend data and utcome of ED patients attending with acute illict drug toxicity.
The purpose of this research is to establish the introduction of a robust toxicology surveillance system in the Emergency Department (ED) in order to inform public health interests. The study will explore the feasibility of reporting characteristics and causative agents of patients attending hospital as an emergency due illicit substance use. The term illicit substance used during this study encompasses any substance which is not prescribed to the individual and is a controlled drug as per the Misuse of Drugs act 1971 and Misuse of Drugs Regulations 2001. The study will look at standard care clinical data from all individuals attending the Emergency Department due to acute illicit drug toxicity. Surplus blood samples will be anonymised and analysed for toxicological profiling. The study will allow identification of emerging drug trends and will be shared contemporaneously with Public Health Scotland and inform the Scottish Government of current incidences to inform public health measures to tackle the drugs death crisis.
Study Type
OBSERVATIONAL
Enrollment
1,000
Anonymised surplus blood sample will be analysed for drugs and their metabolites by way of Mass Spectrometry and LGC Group, Cambridge.
Queen Elizabeth University Hospital, NHS GGC
Glasgow, United Kingdom
RECRUITINGProportion of full data sets and toxicology analysis for all patient attending the ED due to acute illicit drug toxicity
Objective: Assess the feasibility of prospective surveillance of Emergency Department presentations relating to acute illicit drug toxicity Outcome measure: Proportion of full data sets and toxicology analysis for all patient attending the ED due to acute illicit drug toxicity
Time frame: 1 year
Clinical phenotyping of patients attending due to acute illicit drug toxicity compared to reported / presumed drug taken
Objective: Describe the clinical characteristics and reported / presumed toxicological profile of drug related presentations to the Emergency Department Outcome measure: Clinical phenotyping of patients attending due to acute illicit drug toxicity compared to reported / presumed drug taken
Time frame: 1 year
Proportion of patients who fit stage 2 criteria with biological sample mass spectrometry toxicology analysis
Objective: Establish the feasibility of ED presentation toxicological surveillance by anonymised surplus sample mass spect analysis Outcome Measure: Proportion of patients who fit stage 2 criteria with biological sample mass spectrometry toxicology analysis
Time frame: 1 year
Production of frequency and trend data to deliver to Public Health Scotland
Objective: Describe the frequency and trends of drug related presentations to the ED, both clinically and by biological sample analysis Outcome measure: Production of frequency and trend data to deliver to Public Health Scotland
Time frame: 1 year
Proportion of illicit drug reported to have been taken and proportion of clinician presumed drug taken accurately matching toxicology analysis
Objective: Assess the accuracy of reported / clinician presumptive toxidrome diagnosis compared to biological sample analysis Outcome Measure: Proportion of illicit drug reported to have been taken and proportion of clinician presumed drug taken accurately matching toxicology analysis
Time frame: 1 year
Production of automated pre-defined data capture, recording and auditing for the routine processing of drug related ED presentations that includes toxicological information
Objective: Develop a framework to standardise data capture, recording and auditing for the routine processing of drug related ED presentations that includes toxicological information Outcome measure: Production of automated pre-defined data capture, recording and auditing for the routine processing of drug related ED presentations that includes toxicological information
Time frame: 1 year
Share learning and data with Scottish Government, PHS and other NHS boards to inform national scale up
Objective: Identify and compare options for national scale up - including the use of existing hospital toxicology facilities and additional services Outcome measure: Share learning and data with Scottish Government, PHS and other NHS boards to inform national scale up
Time frame: 1 year
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