Estimating the prevalence of problem drug use from drug‐related mortality data.

Background and Aims: Indirect estimation methods are required for estimating the size of populations where only a proportion of individuals are observed directly, such as problem drug users (PDUs). Capture–recapture and multiplier methods are widely used, but have been criticized as subject to bias....

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Publicado en:Addiction Vol. 115; no. 12; pp. 2393 - 2405
Autores principales: Jones, Hayley E., Harris, Ross J., Downing, Beatrice C., Pierce, Matthias, Millar, Tim, Ades, A. E., Welton, Nicky J., Presanis, Anne M., De Angelis, Daniela, Hickman, Matthew
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2020
Acceso en línea:Ver este registro en EBSCOhost
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      place: Malden, Massachusetts
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        atl: Estimating the prevalence of problem drug use from drug‐related mortality data.
      aug:
        au:
          Jones, Hayley E.
          Harris, Ross J.
          Downing, Beatrice C.
          Pierce, Matthias
          Millar, Tim
          Ades, A. E.
          Welton, Nicky J.
          Presanis, Anne M.
          De Angelis, Daniela
          Hickman, Matthew
        affil: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
      sug:
        subj:
          Drug Toxicity Mortality
          Data Collection Methods
          Persons Who Use Intravenous Drugs
          Databases, Health
          Human
          Prospective Studies
          Models, Statistical
          Regression
          Descriptive Statistics
          Adolescence
          Adult
          Middle Age
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
      ab: Background and Aims: Indirect estimation methods are required for estimating the size of populations where only a proportion of individuals are observed directly, such as problem drug users (PDUs). Capture–recapture and multiplier methods are widely used, but have been criticized as subject to bias. We propose a new approach to estimating prevalence of PDU from numbers of fatal drug‐related poisonings (fDRPs) using linked databases, addressing the key limitations of simplistic 'mortality multipliers'. Methods: Our approach requires linkage of data on a large cohort of known PDUs to mortality registers and summary information concerning additional fDRPs observed outside this cohort. We model fDRP rates among the cohort and assume that rates in unobserved PDUs are equal to rates in the cohort during periods out of treatment. Prevalence is estimated in a Bayesian statistical framework, in which we simultaneously fit regression models to fDRP rates and prevalence, allowing both to vary by demographic factors and the former also by treatment status. Results: We report a case study analysis, estimating the prevalence of opioid dependence in England in 2008/09, by gender, age group and geographical region. Overall prevalence was estimated as 0.82% (95% credible interval = 0.74–0.94%) of 15–64‐year‐olds, which is similar to a published estimate based on capture–recapture analysis. Conclusions: Our modelling approach estimates prevalence from drug‐related mortality data, while addressing the main limitations of simplistic multipliers. This offers an alternative approach for the common situation where available data sources do not meet the strong assumptions required for valid capture–recapture estimation. In a case study analysis, prevalence estimates based on our approach were surprisingly similar to existing capture–recapture estimates but, we argue, are based on a much more objective and justifiable modelling approach.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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