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Journal update
Journal update monthly top five
  1. Danielle Mclaughlan1,
  2. Liam Barrett2,
  3. Jessica Hindley1,
  4. Hayley Digby1,
  5. Tania Alves1,
  6. Terence McLoughlin1
  1. 1 Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
  2. 2 Radcliffe Department of Medicine, University of Oxford, Oxford, UK
  1. Correspondence to Ms Danielle Mclaughlan; Danielle.mclaughlan1{at}liverpoolft.nhs.uk

https://doi.org/10.1136/emermed-2024-214496

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    This month’s update is by the Liverpool Emergency Department Research Unit Strategy Team. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper. There were no competing interests from any of the authors.

    The papers are ranked as:

    • Worth a peek—interesting, but not yet ready for prime time.

    • Head turner—new concepts.

    • Game changer—this paper could/should change practice.

    Community-based cluster-randomised trial to reduce opioid overdose deaths by the HEALing Communities Study Consortium

    Topic: Toxicology

    Outcome rating: Worth a peek

    Samet et al aimed to address the opioid crisis in the USA through community-level interventions using a cluster-randomised trial design.1 Thirty-four communities were assigned to the intervention group, implementing evidence-based practices such as naloxone distribution, and 33 communities were assigned to no intervention. The primary outcome was opioid-related overdose deaths among community adults between June 2021 and June 2022.

    By the comparison year, there was no significant difference in opioid-related deaths between the intervention and control group (47.2 deaths per 100 000 population vs 51.7 per 100 000 population, p=0.30).

    Of 615 proposed strategies, only 235 strategies had been initiated by the comparison year, largely due to the workforce depletion and logistical challenges exacerbated by the COVID-19 pandemic.

    In addition, the large number of strategies made effective implementation difficult and prevented the determination of which strategies were effective. Generalisability of the findings may be limited as it was conducted during the pandemic. Nevertheless, the study suggests a new model for implementation of strategies, going beyond individual clinics or hospitals.

    Bottom line: implementation of multiple evidence-based strategies at the community level did not reduce opioid overdose deaths in this study.

    A hospice transitions program for patients in the emergency department by Baugh et al

    Topic: End of life Care

    Outcome rating: Head Turner

    Patients who …

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    Footnotes

    • X @liam126

    • Contributors DM, JH, HD, TA and TM identified appropriate papers to be considered for inclusion and authored all reviews. LB edited all reviews for content and is the guarantor. DM led the team and was responsible for submission. LB conducted the search. The top five papers were selected as a group. Summaries were written by DM, TM, JH, TH and HD. LB reviewed the summaries and made edits to the revisions.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer-reviewed.