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Prevalence of alcohol and other drug use in patients presenting to hospital for fall-related injuries: a systematic review
  1. Georgina Lau1,
  2. Jia Ying Ang1,
  3. Nayoung Kim1,
  4. Belinda J Gabbe1,2,
  5. Biswadev Mitra1,3,4,
  6. Paul M Dietze1,5,6,
  7. Sandra Reeder1,7,
  8. Ben Beck1,8
  1. 1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2Health Data Research UK, Swansea University, Swansea, UK
  3. 3National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia
  4. 4Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
  5. 5Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
  6. 6National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
  7. 7Central Clinical School, Monash University, Melbourne, Victoria, Australia
  8. 8Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
  1. Correspondence to Dr Ben Beck, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; ben.beck{at}monash.edu

Abstract

Background Alcohol and other drug (AOD) use is a key preventable risk factor for serious injuries. Prevention strategies to date have largely focused on transport injuries, despite AOD use being a significant risk factor for other injury causes, including falls. This systematic review aimed to report the prevalence of AOD use in patients presenting to hospital for fall-related injuries.

Methods This systematic review includes studies published in English after the year 2010 that objectively measured the prevalence of AOD use in patients presenting to hospital for a fall-related injury. Screening, data extraction and risk of bias assessments were completed by two independent reviewers. Data were presented using narrative synthesis and, where appropriate, meta-analyses.

Results A total of 12 707 records were screened. Full texts were retrieved for 2042 records, of which 29 were included. Four studies reported the combined prevalence of any alcohol and/or drug use, generating a pooled prevalence estimate of 37% (95% CI 25% to 49%). Twenty-two records reported on the prevalence of acute alcohol use alone and nine reported specifically on the prevalence of drugs other than alcohol, with prevalence ranging from 2% to 57% and 7% to 46%, respectively. The variation in prevalence estimates likely resulted from differences in toxicology testing methods across studies.

Conclusions AOD exposure was common in hospitalised fall-related injuries. However, research addressing prevalence across different types of falls and the use of drugs other than alcohol was limited. Future research should address these areas to improve our understanding of which populations should be targeted in AOD and injury prevention strategies .

PROSPERO registration number CRD42020188746.

  • Fall
  • Alcohol
  • Drugs
  • Systematic Review
  • Metanalysis

Data availability statement

Data are available upon request.

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Data availability statement

Data are available upon request.

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Footnotes

  • Twitter @EmergTrauma, @DrBenBeck

  • Contributors GL is guarantor for this study and was involved in the conceptualisation of the study, conducting searches, abstract and full text screening, data extraction, risk of bias assessments, data analyses and drafting of the original manuscript. JYA was involved in abstract and full text screening and risk of bias assessments. NK was involved in full text screening and risk of bias assessments. BJG, BM, PMD, SR and BB were involved in the conceptualisation of the study and critical revision of the manuscript.

  • Funding GL was supported by an Australian Government Research Training Programme Scholarship (not applicable) and a Westpac Future Leaders Scholarship (not applicable). BJG was supported by National Health and Medical Research Council Investigator Grant (L2, ID 2009998). PMD was supported by a National Health and Medical Research Council Senior Research Fellowship (1136090). BB was supported by an Australian Research Council Discovery Future Fellowship (FT210100183).

  • Competing interests PMD has received investigator-driven funding from Gilead Sciences and an untied educational grant from Indivior for work unrelated to this study and has served as an unpaid member of an advisory board for Mundipharma. All other authors declare no conflicts of interest.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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