Academic Journal
Care trajectories of Quebec patients with substance-related disorders within five years before death.
| Τίτλος: | Care trajectories of Quebec patients with substance-related disorders within five years before death. |
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| Συγγραφείς: | Fleury MJ; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, H3A 1A1 Quebec, Canada; Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, H4H 1R3 Quebec, Canada. Electronic address: flemar@douglas.mcgill.ca., Cao Z; Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, H4H 1R3 Quebec, Canada. Electronic address: Zhirong.Cao@douglas.mcgill.ca., Grenier G; Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, H4H 1R3 Quebec, Canada. Electronic address: guy.grenier@douglas.mcgill.ca. |
| Πηγή: | Psychiatry research [Psychiatry Res] 2026 Jul; Vol. 361, pp. 117130. Date of Electronic Publication: 2026 Mar 31. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Ireland NLM ID: 7911385 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7123 (Electronic) Linking ISSN: 01651781 NLM ISO Abbreviation: Psychiatry Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: Limerick : Elsevier/North-Holland Biomedical Press Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press. |
| Ιατρικοί όροι (MeSH): | Substance-Related Disorders*/therapy , Substance-Related Disorders*/mortality , Substance-Related Disorders*/epidemiology, Quebec/epidemiology ; Mental Disorders/epidemiology ; Humans ; Male ; Female ; Adult ; Middle Aged ; Cause of Death ; Quality of Health Care ; Young Adult ; Aged |
| Περίληψη: | Aims: This study identifies care trajectories five years before death of 1468 patients with substance-related disorders (SRDs), associated with the patients' social and clinical characteristics, quality of care received, and causes of death. Methods: Care trajectories integrated outpatient SRD, mental health (MH) and physical health care, and acute care. Group-based multi-trajectory modeling identified service use patterns in three-month intervals across the five years preceding death. Multinomial logistic regression assessed associations between trajectory membership, patient characteristics, quality of care received, and causes of death. Results: Four distinct trajectories emerged: "Low service users" (Profile 1, 34 % of sample, the reference group), "High physical health service users" (Profile 2, 30 %), "High but decreasing SRD service users" (Profile 3, 15 %), and "High but decreasing mental disorder (MD) service users, high users of other services" (Profile 4, 21 %). Profile 1 comprised mostly younger men with better health but poor continuity and regularity of care. Profile 3 patients had the most severe conditions, received the most intensive care, but had more accidental/intentional deaths than Profile 1. Profile 2 included older patients with severe chronic physical illnesses, injection drug use, and more emergency department users than Profile 1. Profile 4 had older patients reporting more MDs, suicidal behaviors, lower functioning, and greater use of specialized MH care. Conclusion: Service use was low overall and remained low even near death. Physical health care was the most used, followed by acute care. SRD and MH care declined before death across all profiles. Tailored interventions for each profile are suggested. (Copyright © 2026 Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Acute care; Care trajectories; Co-occurring disorders; Outpatient treatment; Service use; Substance-related disorders, Death |
| Entry Date(s): | Date Created: 20260405 Date Completed: 20260714 Latest Revision: 20260714 |
| Update Code: | 20260715 |
| DOI: | 10.1016/j.psychres.2026.117130 |
| PMID: | 41936158 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1872-7123 |
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| DOI: | 10.1016/j.psychres.2026.117130 |