Decision support in addiction: the development of an e-health tool to assess and prevent risk of fatal overdose. The ORION project

Background and Objective. The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose. Methods. In this article we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project. Results. The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception. Conclusion. Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness.PostprintPeer reviewe

Wissenschaftliche Begründung der STIKO für die COVID-19-Impfempfehlung für Kinder im Alter von 6 Monaten bis 4 Jahren sowie zur Anpassung der COVID-19-Impfempfehlung für Kinder im Alter von 5 – 11 Jahren

Am 19.10.2022 wurden in der EU die mRNA-Impfstoffe Comirnaty und Spikevax für die Grundimmunisierung gegen COVID-19 im Kleinkindalter zugelassen. Comirnaty wird in einer Dosierung von 3 μg mit einem 3-Dosenimpfschema für Kinder im Alter von 6 Monaten bis 4 Jahren bereitgestellt. Spikevax ist in einer Dosierung von 25 μg mit einem 2-Dosenimpfschema für Kinder im Alter von 6 Monaten bis 5 Jahren zugelassen. Die STIKO gibt einen Überblick über die wissenschaftlichen Daten aus den Zulassungsstudien der beiden mRNA-Impfstoffe für Kleinkinder im Alter von 6 Monaten bis 4 bzw. 5 Jahren und hat geprüft, ob somit für diese Altersgruppe eine Impfempfehlung ausgesprochen werden soll. Zum anderen hat die STIKO vor dem Hintergrund der aktuellen Evi¬denzlage ihre Impfempfehlungen für Kinder im Alter von 5 bis 11 Jahren angepasst. Dies betrifft vor allem die Grundimmunisierung immungesunder Kinder dieser Altersgruppe, in deren Umfeld sich Angehörige oder andere Kontaktpersonen mit hohem Risiko für einen schweren COVID-19-Verlauf befinden.Peer Reviewe

Decision support in addiction: the development of an e-health tool to assess and prevent risk of fatal overdose. The ORION project

Background and Objective. The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose. Methods. In this article we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project. Results. The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception. Conclusion. Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness

Predictors of service use of patients with co-morbid mental health and substance use disorders across seven European sites

The purpose of this study was to identify factors which predict service use over time in patients with co-morbid mental health and substance use disorders (dual diagnosis). Three hundred and fifty-two patients with dual diagnosis were recruited from acute psychiatric inpatient units at seven European sites. At baseline and 9 months follow-up, socio-demographic and clinical information, as well as information concerning the use of treatment services was collected. Predictors for use of psychiatric and substance misuse services at follow-up were studied using multinomial logistic regression models. At follow-up, patients with dual diagnosis used psychiatric services significantly more than substance use services. The main predictor of service use at follow-up is influenced by the study site and not by psychopathology. More networking and signposting are needed especially for substance misuse services. Service provision and planning can improve access of vulnerable populations even when psychopathology improves

Predictors of service use of patients with co-morbid mental health and substance use disorders across seven European sites

The purpose of this study was to identify factors which predict service use over time in patients with co-morbid mental health and substance use disorders (dual diagnosis). Three hundred and fifty-two patients with dual diagnosis were recruited from acute psychiatric inpatient units at seven European sites. At baseline and 9 months follow-up, socio-demographic and clinical information, as well as information concerning the use of treatment services was collected. Predictors for use of psychiatric and substance misuse services at follow-up were studied using multinomial logistic regression models. At follow-up, patients with dual diagnosis used psychiatric services significantly more than substance use services. The main predictor of service use at follow-up is influenced by the study site and not by psychopathology. More networking and signposting are needed especially for substance misuse services. Service provision and planning can improve access of vulnerable populations even when psychopathology improves