COVID-19-Related Death in Patients with Alcohol or Substance Use Disorders.

BACKGROUND: People with substance or alcohol use disorders (SUDs/AUDs) are likely to be more vulnerable to COVID-19 infection than the general population, but the evidence of COVID-19-related mortality in these patients is unclear. OBJECTIVES: The aim of the study was to verify whether patients with AUD and SUD have a higher mortality rate for COVID-19-related mortality compared to the general population. METHOD: We performed a follow-up study to assess mortality in 2020 in a cohort of patients diagnosed for the first time with AUDs or SUDs at the Public Health Services in the metropolitan area of Bologna (Northern Italy) from 2009 to 2019. RESULTS: SUDs/AUDs patients present an excess mortality with respect to the general population for all causes of death and for COVID-19-related mortality. CONCLUSIONS: Our data support the need for prevention strategies in SUDs/AUDs patients such as vaccinations.

"Co-production Compass" (COCO): An Analytical Framework for Monitoring Patient Preferences in Co-production of Healthcare Services in Mental Health Settings.

Background: Engaging patients in raising their voices to advocate for their priorities being taken into account is today acknowledged as essential to improve research and decision-making in healthcare. However, literature is scarce regarding an evaluation framework to monitor the extent to which this approach is successful, in particular in mental health, where the application of patient-reported outcome measures (PROMs) is particularly difficult. In this study, we describe the process of development and first implementation of a new assessment framework-"Co-production Compass" (COCO) framework-for monitoring patient preference collection in co-production of healthcare services within the scope of a national-based project (namely, Recovery.Net) in the mental health field. Method: We conducted (1) a narrative scan of relevant scientific literature on patient engagement in service co-production and (2) qualitative analysis of five subsequent workshops involving-in total-144 expert stakeholders (i.e., expert patients, doctors, nurses, psychologists, healthcare managers…). Data analysis involved three phases: identifying the themes, developing a framework, and confirming the framework. We coded and organized the data and abstracted, illustrated, described, and explored the emergent themes using thematic analysis. At the same time, content analysis was conducted to retrieve concepts and insights from relevant literature about health services co-production to integrate and extend the emergent conceptual framework. The framework was finally reviewed by the research partners belonging to the study project and preliminarily implemented. Results: According to the results of both the literature scan and the participatory workshops, the COCO evaluation framework for monitoring patient preference collection when coproducing medical pathways was drafted. The framework comprised of three organizing themes, corresponding to the three code clusters, which emerged from both the stakeholders' workshop data and relevant scientific literature: "the need for shared and practice-oriented evaluation standards"; "the quest for a multi-dominion approach"; "the need for a multi-stakeholder evaluation". These themes were interconnected and formed a conceptual framework to measure the phenomenon of meaningful patient involvement in healthcare co-production. This framework was endorsed by the research partners of the project and preliminarily applied in a mental health setting. Conclusion: The COCO framework provides guidance on aspects of co-production in healthcare to address for meaningful patient involvement in giving their inputs for more effective service and drug development processes. It could be particularly useful when monitoring patient-researcher partnership initiatives.

[Mental Health Recovery Star: features and validation study of the Italian version]. / La Mental Health Recovery Star: caratteristiche e studio di validazione della versione italiana.

AIM: Mental Health Recovery Star (MHRS) is an instrument that helps to assess recovery processes of mental health patients through a collaborative approach. The aim of the study is to describe the features of the instrument and to report the results of the Italian validation study. METHODS: The study involved 117 users which were evaluated in two phases. Besides MRHS, HoNOS, WHOQoL-brief, GAF were used. Acceptability for users and key-workers of the instruments and its main psychometric properties, as test-retes (ICC) and concurrent validity (Pearson's correlation coefficient), were evaluated. RESULTS: MHRS showed to have temporal stability in all its areas. Significant correlations were found between the MHRS and the most closely related areas of the scales used. Inter-rater reliability were studied in an unsatisfactory way. MHRS was appreciated and easy to use. Collaborative evaluations were completed mostly in less than 45 minutes. CONCLUSIONS: MHRS is an acceptable tool for users and staff-members, distinguishing itself from the use of useful visual aids; helps to identify the patient's recovery path and supports a collaborative approach between user and operator. The results of the psychometric properties of the instrument appeared promising but not exhaustive. Although further efforts should be addressed to the implementation of such aspects of the instrument and reflections should be raised with respect to the traditional methods to detect the complex meaning of recovery (subjective-objective aspects), the valuable collaborative contribution of MHRS can not be denied in favoring the user's responsibility and supporting the professional worker in his role of case manager.