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Prevalence and risk factors of emergency department presentations with methamphetamine intoxication or dependence: A systematic review and meta-analysis
journal contributionposted on 2022-05-18, 04:03 authored by Njabulo C Sibanda, Rachel Kornhaber, Glenn E Hunt, Kirsten Morley, Michelle ClearyMichelle Cleary
Background: Methamphetamine intoxication presentations to emergency departments (EDs) including trauma centres, general EDs and psychiatric emergency services have risen world-wide. Objectives: A review of the clinical characteristics of patients presenting to a trauma centre or ED with methamphetamine intoxication or dependence to aid development of health service policy and training for health personnel. Methods: PubMed, PsycINFO, CINAHL and Scopus (1990–2017) were searched. A systematic review of all clinical characteristics was conducted, and a meta-analysis undertaken for variables with standard measures (prevalence, age, gender); 23 studies met the inclusion criteria of which 17 could be used in the meta-analysis. Results: Methamphetamine-related presentations were characterised by cardiac complications, psychiatric symptoms and aggression with safety risk to health personnel. The pooled prevalence of methamphetamine positive cases in emergency settings was higher in studies using toxicology analysis to determine methamphetamine use (8 studies, 22.8% 95% CI 15.4–32.5) compared to self-reporting (9 studies 5.7%, 95% CI 2.8–11.2, Q = 12.42, p < 0.001). Pooled variance of methamphetamine positive cases was 57.1% in men and 42.9% in women. The mean age of those who were methamphetamine positive was 28.4 years and for those methamphetamine negative cases it was 38.4 years. Conclusions: In this review, we found a higher prevalence of methamphetamine use amongst males and in the younger demographic. Targeted training programmes for frontline staff and management approaches for prompt multi-disciplinary service engagement are recommended as well as appropriate resourcing, such as mental health staff in EDs or mental health beds to accommodate this subgroup of the patient cohort.
Number of Pages12
External Author AffiliationsUniversity of Sydney; University of Tasmania
JournalIssues in Mental Health Nursing
Emergency departmentMethamphetamine intoxicationTrauma centresPsychiatric emergency servicesSafety risk to health personnelTraining programmesFrontline staffAdolescentAdultAgedAmphetamine-Related DisordersEmergency Service, HospitalFemaleHumansMaleMiddle AgedPrevalenceRisk FactorsYoung AdultPrimary Health Care