Abstract 2 - Real-world effectiveness of follow-up care with novel strategies on the reduction of suicidal attempts risk among patients with DUD during the COVID-19 pandemic in Tainan city (Tainan Healthy City Association)

Abstract 2

Real-world effectiveness of follow-up care with novel strategies on the reduction of suicidal attempts risk among patients with DUD during the COVID-19 pandemic in Tainan city.

Background: The follow-up care was the mainstay strategy for patients with drug use disorder (DUD). However, patients may have more stressful and constrained conditions during the COVID-19 pandemic, compromising the effects of follow-up on preventing suicidal risk. Therefore, Tainan metropolitan city implemented two strategies during the follow-up care to improve the quality of care, including (1) using 5-item Brief Symptom Rating Scale (BSRS-5) to identify high suicidal risk patients, ;and (2) performing “Parallel-track Case Managers” program to facilitate a better connection of patients between hospitals and district health centers.

Objective: The study aimed to evaluate the effectiveness of follow-up care with the novel strategies on the risk of suicidal attempts during the COVID-19 pandemic.;Methods;We conducted a case-crossover study by analyzing the data from the National Suicide Prevention Reporting System and the Drug Abuse Case Management System (DACMS). We included patients who were enrolled in DACMS program for DUD with a record of suicidal attempt from March 2020 to June 2021 in Tainan.The first date of suicide attempt was considered as event date.The dates 6 months (i.e., the wash-out period) prior to the event date was considered as reference date. The exposure group was defined as those with a record of follow-up within 30 days before event dates or reference date; otherwise, patients were considered as non-exposure group.We performed conditional Poisson regression to obtain the odds ratios (OR) and the confidence intervals (CI) to evaluate the risk of suicidal attempts between exposure and non-exposure to follow-up care.

Findings: We included a total of 133 cases with records of suicidal attempts in this study. The mean age is 40.9 (SD11.6) and 60% were male. We found patients with follow-up care were associated with reduced risk of suicidal attempts (OR = 0.86; 95% CI = 0.46-1.61).

Application: Although no statistical significance due to relatively small sample size, we found the follow-up care with the novel strategies tended to associate with lower suicidal attempts risk in patients with DUD. The findings suggested that the novel strategies merit consideration as adjuvants of follow-up care in patients with DUD until others prove otherwise.

Keywords: suicidal attempts, drug use disorder, follow-up care, Parallel-track Case Managers