Ambulance Calls for Substance Use and Alcohol in a Pandemic (ASAP) (ASAP)

Ambulance Calls for Substance Use and Alcohol in a Pandemic (ASAP): Exploring Attendance at Incidents Involving Substance and/or Alcohol Use During COVID-19 Pandemic

The Primary objective is to explore ambulance service attendance at incidents involving alcohol and/or substance use over the period of the pandemic lockdown, and the following months. This will be to determine prevalence and explore factors such as patient gender, age, ethnicity or location. Analysis will examine the calls over the course of the year prior to the lockdown, and then compare this to the period of lockdown and following months.

Study Overview

• Status: Completed
• Conditions: Emergencies; Substance Use; Treatment; Alcohol Use, Unspecified; COVID-19 Pandemic; Intoxication Alcohol
• Intervention / Treatment: Other: attendance by ambulance crew

Detailed Description

The Primary objective is to explore ambulance service attendance at incidents involving alcohol and/or substance use over the period of the pandemic lockdown, and the following months. This will be to determine prevalence and explore factors such as patient gender, age, ethnicity or location. Analysis will examine the calls over the course of the year prior to the lockdown, and then compare this to the period of lockdown and following months.

A time series analysis will be conducted to examine the calls over the course of the year prior to the lockdown, and then compare this to the period of lockdown and following months. This will use the 'Interrupted Time Series' (ITS) approach. To explore this regression models will be built that examine the causal models for attendance prior to the pandemic and compared to the lockdown time frame.

A multivariable regression model will be built. Initially a Directed Acyclic Graph (DAG) will allow the identification of confounders and exposures relevant to the model. A logistic regression model will be used to calculate the relative risk of call during lockdown compared to the data prior to lockdown. The model will be fit using p<0.05 as the definition of statistical significance.

Descriptive statistics, trend analysis and predictive analysis will be conducted on the data set to determine trends across time, factors that predict patients requiring ambulance attendance, and factors that predict treatment outcomes. Missing data will be examined for systematic bias, and where found to be missing at random will be excluded from analysis. Where not missing at random, sensitivity analysis will be conducted.

Analysis will examine covariates. Age will be defined as single year continuous variable and examined in categories such as 5-year age groups. Ethnicity will be categorised as groups, such as black, Asian, other minority and mixed ethnic groups will be explored. Census data such as the deprivation, rurality, income, employment, disability and education will look at the decile as defined.

• Study Type: Observational
• Enrollment (Actual): 55000

Contacts and Locations

Study Locations

• United Kingdom
  • Lincoln, United Kingdom, LN64PB
    • University of Lincoln

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All people who ring 999 or 111 in an emergency.

Description

Inclusion Criteria:

• Patient of any age
• Patient requested ambulance attendance between 23rd March 2019 and 22nd March 2021
• The patient record is held by East Midlands Ambulance Service
• Patient records that have recorded a clinical impression related to alcohol and substance use will be included in the data set alongside a word search in the free text response box for the following words/phrases: narcotic, spice, mamba, alcohol, substance use, drug use, illicit drug, overdose, intoxication, intoxicated, drunk, high.

Exclusion Criteria:

• The patient record was outside of the indicated date range.
• The patient record is not accessible via EMAS

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Hear and treat; phone call, treatment, not attended
See and treat; Ambulance crew attended	Other: attendance by ambulance crew; hear, attendance, convey

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attendances for alcohol and drug use	Counts of attendances for alcohol and drug use by the East Midland's Ambulance Service over the time period. This will be a number per day of people attended.	Full data set 23/03/2019 compared to 22/03/2021 to look at interruption (lockdown) in the time series.

Collaborators and Investigators

• Sponsor: University of Lincoln
• Investigators: Principal Investigator: Graham Law, PhD, University of Lincoln

Study record dates

Study Major Dates

• Study Start (Actual): March 23, 2019
• Primary Completion (Actual): March 23, 2021
• Study Completion (Actual): March 23, 2021

Study Registration Dates

• First Submitted: July 12, 2020
• First Submitted That Met QC Criteria: July 15, 2020
• First Posted (Actual): July 16, 2020

Study Record Updates

• Last Update Posted (Estimated): December 11, 2024
• Last Update Submitted That Met QC Criteria: December 10, 2024
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease Attributes; Respiratory Tract Infections; Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Lung Diseases; Chemically-Induced Disorders; Drinking Behavior; Alcohol-Related Disorders; Pneumonia, Viral; Pneumonia; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; COVID-19; Emergencies; Alcohol Drinking; Substance-Related Disorders; Alcoholic Intoxication
• Other Study ID Numbers: ASAP01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: There is no plan to share the IPD

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No