{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:08:38Z","timestamp":1779890918765,"version":"3.53.1"},"reference-count":98,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Fonds de recherche du Qu\u00e9bec \u2013 Sant\u00e9","award":["13207"],"award-info":[{"award-number":["13207"]}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["436351"],"award-info":[{"award-number":["436351"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,7]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The main harm reduction interventions for people who inject drugs (PWID) are supervised injection facilities, needle and syringe programmes and opioid agonist treatment. Current evidence supporting their implementation and operation underestimates their usefulness by excluding skin, soft tissue and vascular infections (SSTVIs) and anoxic\/toxicity-related brain injury from cost-effectiveness analyses (CEA). Our goal is to conduct a comprehensive CEA of harm reduction interventions in a setting with a large, dispersed, heterogeneous population of PWID, and include prevention of SSTVIs and anoxic\/toxicity-related brain injury as measures of benefit in addition to HIV, hepatitis C and overdose morbidity and mortalities averted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This protocol describes how we will develop an open, retrospective cohort of adult PWID living in Qu\u00e9bec between 1 January 2009 and 31 December 2020 using administrative health record data. By complementing this data with non-linkable paramedic dispatch records, regional monthly needle and syringe dispensation counts and repeated cross-sectional biobehavioural surveys, we will estimate the hazards of occurrence and the impact of Montr\u00e9al\u2019s harm reduction interventions on the incidence of drug-use-related injuries, infections and deaths. We will synthesise results from our empirical analyses with published evidence to simulate infections and injuries in a hypothetical population of PWID in Montr\u00e9al under different intervention scenarios including current levels of use and scale-up, and assess the cost-effectiveness of each intervention from the public healthcare payer\u2019s perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was approved by McGill University\u2019s Institutional Review Board (Study Number: A08-E53-19B). We will work with community partners to disseminate results to the public and scientific community via scientific conferences, a publicly accessible report, op-ed articles and open access peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053191","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T13:40:20Z","timestamp":1635255620000},"page":"e053191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating Montr\u00e9al\u2019s harm reduction interventions for people who inject drugs: protocol for observational study and cost-effectiveness analysis"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6175-3634","authenticated-orcid":false,"given":"Dimitra","family":"Panagiotoglou","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Abrahamowicz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Research Institute, McGill University Health Centre, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L","family":"Buckeridge","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Clinical and Health Informatics Research Group, Department of Medicine, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Jaime","family":"Caro","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Evidera, Boston, Massachusetts, USA"},{"name":"London School of Economics and Political Science, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Latimer","sequence":"additional","affiliation":[{"name":"Douglas Research Institute, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Department of Psychiatry, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Maheu-Giroux","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin C","family":"Strumpf","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Department of Economics, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"2025121509315774000_11.10.e053191.1","unstructured":"Riley D , Pates R , Monaghan G , et al . 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