Theme: Epidemiology and Public Health Research Year: 2021
Background: An estimated 68,297 people with opioid use disorder engaged in opioid agonist therapy in Spain during 2017. We aimed to calculate the incidence of severe injection-related infections in people who inject drugs (PWID) engaged in opioid agonist therapy (OAT) in harm reduction settings without a safe consumption space (SCS). Methods: A retrospective cohort study was performed in PWID engaged in (OAT) and in a mobile harm reduction unit to quantify admissions to a referral hospital for any severe injection-related infections between 1 January 2016 and 31 December 2019. A Cox proportional hazard regression analysis was used to assess factors associated with any severe injection-related infection. Results: 237 PWID who engaged in OAT were included in the study. After a median follow-up of 5.5 months (IQR 1.3–22.7), a total of 104 episodes of severe injection-related infections occurred among 56 individuals, and admission due to a second event occurred in 35.7% of this same group. The incidence density of any type of severe injection-related infection was 26.8 (20.2–34.8) episodes per 100 person-years, and the incidence density of complicated skin and soft tissue infections that required hospital admission was 20.4 (15.0–27.3) episodes per 100 person-year. Fifty-six (53.8%) of all the episodes were patient-directed discharge, and people who had two or more hospital admissions had a higher PDD frequency. Conclusion: Severe injection-related infections remain highly prevalent among PWID cared for in a harm reduction setting without a SCS. Patient-directed discharge was more frequent among higherrisk individuals who presented two or more hospital readmissions. Disclosure of Interest: Gilead sciences and Abbie grants were received in the development of this study
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