Evaluation of overdose surveillance at overdose prevention sites in Vancouver, Canada, 2019.

  • Public health surveillance
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Background:
In 2016 a public health emergency was declared in British Columbia, Canada due to an increase in drug-related overdoses and deaths. This allowed for rapid public health response, including the implementation of overdose prevention sites (OPSs). OPSs are low-barrier sites that offer supervised drug consumption and other harm reduction services. Overdose response at OPSs is performed by staff generally consisting of volunteers and peers with lived experience. Surveillance at OPSs monitors for trends in overdose events to inform public health action. In 2019, an evaluation was conducted to assess if the surveillance system was meeting objectives.

Methods:
A mixed Methods: approach was used to evaluate three surveillance system attributes: acceptability, usefulness, and data quality. All three attributes were evaluated qualitatively through OPS visits (n=6) and informal conversational interviewing with site staff (n=20). Data quality was further assessed quantitatively by comparing line-list to aggregate data collected by the sites in 2018.

Results:
Respondents generally indicated that the data collection experience was acceptable; the data collection form was straightforward and easy to understand. Respondents indicated information in the weekly report was useful but reported variability in the extent to which they reviewed the data. OPS visits and overdoses were recorded and/or entered differently across sites, making data comparison across sites difficult. Variance was noted between line-list and aggregate data at most sites due to differences in what was being counted at each site and entered into the system, as well as counting and data entry errors.

Conclusion:
OPSs are an innovative and novel approach to reduce the harms associated with substance use. Overdose surveillance at OPSs provides actionable public health information not otherwise available. The system is acceptable to staff collecting data and data contained in the OPS weekly report is useful. Recommendations on how data is collected and entered have been identified to improve data quality.

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