Prescribers aware: a cross-sectional study from New Zealand emergency departments on the substances used in intentional self-poisoning and their sources
Eeva-Katri Kumpula 1 5 , Bruce Lambie 2 , Paul Quigley 3 , Shyamala Nada-Raja 4 , Pauline Norris 11 School of Pharmacy, University of Otago, Dunedin, New Zealand
2 Department of Emergency Medicine, Dunedin Hospital, Dunedin, New Zealand
3 Department of Emergency Medicine, Wellington Regional Hospital, Wellington, New Zealand
4 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
5 Corresponding author. Email: eeva-katri.kumpula@otago.ac.nz
Journal of Primary Health Care 12(3) 235-243 https://doi.org/10.1071/HC20017
Published: 21 July 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: Intentional self-poisoning or self-harm through poisoning, is a common cause of presentations to emergency departments (EDs). National datasets do not allow identification of the substances most commonly used in hospital-treated intentional self-poisoning in New Zealand, nor do they capture sources of these substances.
AIM: To investigate the specific substances used in intentional self-poisoning and the sources from which they are obtained.
METHODS: In this cross-sectional study, information about the demographics and presentation particulars of intentional self-poisoning patients aged ≥16 years, presenting to three public EDs, as well as the substances they used in the self-poisoning event and the sources of these agents, were collected prospectively.
RESULTS: A total of 102 patients were recruited from the potentially eligible 1137 intentional self-poisoning patients presenting to the three EDs during the study period. Seventy per cent used their own prescription medications and 24% used medicines they purchased themselves. Paracetamol and ethanol were most commonly encountered substances. Patients presented a median of 1.9 h after exposure (interquartile range 1.0–3.3 h), 62% self-referred, 60% presented to the ED in the evening or at night and 66% were triaged into Australasian Triage Scale 3 (to be seen within 30 min). Two-thirds were referred to emergency psychiatric services.
DISCUSSION: Collecting specific substance information, such as from this study, can assist in planning specific activities to prevent intentional self-poisoning. As most people used their prescribed medicines, the findings can inform and assist doctors in their prescribing practices when they manage patients at risk of self-poisoning.
KEYwords: clinical practice; drug poisoning; patient safety; prescription medicines; risk management; suicide
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