Comparing Practices Used in Overdose Fatality Review Teams to Recommended Implementation Guidelines

Objectives: Overdose fatality review teams are a public health and public safety collaboration that reviews fatality cases using a multidisciplinary team to provide recommendations for overdose prevention. No research exists on the case review practices currently being used in these programs. Design: We administered a cross-sectional survey measuring case review practices and perceptions to a convenience sample of overdose fatality review teams. Setting: We administered the online survey to participants at a national virtual forum on overdose fatality review. Participants: In this study, we examined 30 county-level overdose fatality review teams from 6 states who completed the survey. Main Outcome Measures: We developed measures of case review practices from an overdose fatality review implementation guide. We provided descriptive statistics on the survey items used to measure these practices and examined how practice uptake varied by overdose fatality review team characteristics. Results: Most overdose fatality review teams had adequate representation and membership, but none adhered to all of the practices measured from the implementation guide. The largest gap was in perceived effectiveness and implementation of case review recommendations. In addition, teams that had been reviewing cases for longer reported more adherence to recommended practices. Conclusions: Overdose fatality case review is a collaboration between local public health and public safety agencies that holds great promise. However, these teams will require additional training and technical assistance with local community support to ensure that recommendations are actionable.