Characteristics of attrition within the SuperMIX cohort of people who inject drugs: a multiple event discrete-time survival analysis.

IF 3.9 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Shady Abdelsalam, Paul A Agius, Rachel Sacks-Davis, Amanda Roxburgh, Michael Livingston, Lisa Maher, Matthew Hickman, Paul Dietze
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Abstract

Background: Compared to the general population, people who inject drugs have poor health and wellbeing. Longitudinal studies can provide insight into factors driving these worse health outcomes but are subject to methodological challenges, such as cohort attrition. The aim of this study was to assess and characterise attrition in a prospective cohort of people who inject drugs in Victoria, Australia.

Methods: Using annually collected self-reported data from The Melbourne Injecting Drug User Cohort Study (SuperMIX) from September 2008 to January 2021, we estimated the incidence of participants being lost-to-follow-up (LTFU), with an episode of being LTFU defined as participants not undertaking a follow-up interview within two years of their last interview. We utilised a multiple event discrete-time survival analysis on participant period-observation data to estimate the associations between key factors and LTFU. Key areas of exposure measurement in analyses were sociodemographic, drug use and mental health.

Results: A total of n = 1328 SuperMIX participants completed a baseline interview, with n = 489 (36.8%) LTFU, i.e. not completing a follow-up interview in the following two years. Increased attrition was observed among SuperMIX participants who were: born outside Australia, younger than 30 years, reporting having completed fewer years of education, not residing in stable accommodation, not in stable employment and not on opioid agonist therapy (OAT).

Conclusions: The attrition rate of the SuperMIX cohort has largely been stable throughout the duration of the study. Higher attrition rates among individuals at greater sociodemographic disadvantage and not on OAT suggest that additional efforts are required to retain these participants. Findings also suggest that SuperMIX might not be capturing data on adverse health and wellbeing outcomes among subpopulations at high risk of harm.

注射吸毒者 SuperMIX 队列中自然减员的特征:多事件离散时间生存分析。
背景:与普通人群相比,注射吸毒者的健康和福祉较差。纵向研究可以帮助人们深入了解导致这些健康状况恶化的因素,但也面临着方法上的挑战,如队列减员。本研究的目的是评估澳大利亚维多利亚州注射毒品者前瞻性队列中的自然减员情况并确定其特征:我们利用每年从墨尔本注射吸毒者队列研究(SuperMIX)中收集的自我报告数据(2008 年 9 月至 2021 年 1 月),估算了参与者失去随访(LTFU)的发生率。我们对参与者的观察期数据进行了多事件离散时间生存分析,以估计关键因素与 LTFU 之间的关联。分析中的关键暴露测量领域包括社会人口学、药物使用和心理健康:共有n = 1328名SuperMIX参与者完成了基线访谈,其中n = 489人(36.8%)LTFU,即在随后两年内未完成后续访谈。在以下人群中,SuperMIX参与者的自然减员率有所上升:在澳大利亚境外出生、年龄小于30岁、受教育年限较短、没有稳定住所、没有稳定工作以及没有接受阿片类受体激动剂治疗(OAT):在整个研究期间,SuperMIX 群体的流失率基本保持稳定。在社会人口统计学上处于更不利地位且未接受阿片类药物治疗的人群中,流失率较高,这表明需要做出更多努力来留住这些参与者。研究结果还表明,SuperMIX 可能没有收集到高风险亚人群的不良健康和福利结果数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Medical Research Methodology
BMC Medical Research Methodology 医学-卫生保健
CiteScore
6.50
自引率
2.50%
发文量
298
审稿时长
3-8 weeks
期刊介绍: BMC Medical Research Methodology is an open access journal publishing original peer-reviewed research articles in methodological approaches to healthcare research. Articles on the methodology of epidemiological research, clinical trials and meta-analysis/systematic review are particularly encouraged, as are empirical studies of the associations between choice of methodology and study outcomes. BMC Medical Research Methodology does not aim to publish articles describing scientific methods or techniques: these should be directed to the BMC journal covering the relevant biomedical subject area.
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