The Overdose Response with Take Home Naloxone (ORTHN) project: Evaluation of health worker training, attitudes and perceptions.
health worker
naloxone
opioid
overdose
train the trainer
Journal
Drug and alcohol review
ISSN: 1465-3362
Titre abrégé: Drug Alcohol Rev
Pays: Australia
ID NLM: 9015440
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
27
03
2022
received:
03
08
2021
accepted:
28
03
2022
pubmed:
21
4
2022
medline:
7
7
2022
entrez:
20
4
2022
Statut:
ppublish
Résumé
Naloxone is a life-saving medication that reverses opioid overdose; naloxone can be provided on a 'take-home' basis so naloxone can be administered outside of the health-care setting. The Overdose Response and Take Home Naloxone (ORTHN) project established a model of care for take-home naloxone (THN) interventions across alcohol and other drug and harm reduction services in NSW, Australia. This paper evaluates the staff training and credentialing program, and examines staff attitudes and perspectives regarding the provision of THN interventions in these settings. Staff across seven services were trained through a 'train-the-trainer' credentialing model to deliver ORTHN, including naloxone supply. Staff were surveyed regarding their experience, attitudes and knowledge on THN prior to and after training, and after 6 months. At the 6 months follow up, staff were asked about the interventions they provided, barriers and enablers to uptake, and opinions regarding future rollout. A total of 204 staff were trained and credentialed to provide the ORTHN intervention. Most (60%) were nurses, followed by needle syringe program workers and allied health/counsellors (32%). Linear and logistic regression analyses indicated that the training program was associated with significant improvements in staff knowledge and attitudes towards overdose and THN; however, only attitudinal improvements were maintained over time. There were high rates of staff satisfaction with the ORTHN intervention and training. The ORTHN program is 'fit for purpose' for broad implementation in these settings. A number of potential barriers (e.g. time, medication and staffing costs) and enablers (e.g. peer engagement, regulatory framework for naloxone supply) in implementing THN interventions were identified.
Substances chimiques
Narcotic Antagonists
0
Naloxone
36B82AMQ7N
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1085-1094Informations de copyright
© 2022 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.
Références
Melton SH, Melton ST. Current state of the problem: opioid overdose rates and deaths. Curr Treat Options Psychiatry 2019;6:164-77.
Lam T, Kuhn L, Hayman J et al. Recent trends in heroin and pharmaceutical opioid-related harms in Victoria, Australia up to 2018. Addiction 2020;115:261-9.
World Health Organisation. Community management of opioid overdose; 2014. Available at: http://www.who.int/substance_abuse/publications/management_opioid_overdose/en/
Piper TM, Rudenstine S, Stancliff S et al. Overdose prevention for injection drug users: lessons learned from naloxone training and distribution programs in new York City. Harm Reduct J 2007;4:3.
Bennett AS, Bell A, Tomedi L, Hulsey EG, Kral AH. Characteristics of an overdose prevention, response, and naloxone distribution program in Pittsburgh and Allegheny County, Pennsylvania. J Urban Health 2011;88:1020-30.
Bird SM, McAuley A, Perry S, Hunter C. Effectiveness of Scotland's National Naloxone Programme for reducing opioid-related deaths: a before (2006-10) versus after (2011−13) comparison. Addiction 2016;111:883-91.
Dietze PM, Draper B, Olsen A et al. Does training people to administer take-home naloxone increase their knowledge? Evidence from Australian programs. Drug Alcohol Rev 2018;37:472-9.
Dwyer R, Olsen A, Fowlie C et al. An overview of take-home naloxone programs in Australia. Drug Alcohol Rev 2018;37:440-9.
Lintzeris N, Monds LA, Bravo M et al. Designing, implementing and evaluating the overdose response with take-home naloxone model of care: an evaluation of client outcomes and perspectives. Drug Alcohol Rev 2020;39:55-65.
Yarber L, Brownson CA, Jacob RR et al. Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health. BMC Health Serv Res 2015;15:547.
McAuley A, Best D, Taylor A, Hunter C, Robertson R. From evidence to policy: the Scottish national naloxone programme. Drugs Educ Prev Policy 2012;19:309-19.
Madah-Amiri D, Clausen T, Lobmaier P. Utilizing a train-the-trainer model for multi-site naloxone distribution programs. Drug Alcohol Depend 2016;163:153-6.
Dahlem CH, Scalera M, Chen B, McCabe SE, Boyd CJ. Impact of the take action train-the-trainer model of opioid overdose education with naloxone distribution-who benefits? Subst Abus 2020;41:485-92.
Gatewood AK, Van Wert MJ, Andrada AP, Surkan PJ. Academic physicians' and medical students' perceived barriers toward bystander administered naloxone as an overdose prevention strategy. Addict Behav 2016;61:40-6.
Dwyer R, Fraser S, Dietze P. Benefits and barriers to expanding the availability of take-home naloxone in Australia: a qualitative interview study with service providers. Drugs Educ Prev Policy 2016;23:388-96.
Holland TJ, Penm J, Dinh M, Aran S, Chaar B. Emergency department physicians' and pharmacists' perspectives on take-home naloxone. Drug Alcohol Rev 2019;38:169-76.
Green TC, Bowman SE, Zaller ND, Ray M, Case P, Heimer R. Barriers to medical provider support for prescription naloxone as overdose antidote for lay responders. Subst Use Misuse 2013;48:558-67.
Nielsen S, Menon N, Larney S, Farrell M, Degenhardt L. Community pharmacist knowledge, attitudes and confidence regarding naloxone for overdose reversal. Addiction 2016;111:2177-86.
Winograd RP, Werner KB, Green L, Phillips S, Armbruster J, Paul R. Concerns that an opioid antidote could “make things worse”: profiles of risk compensation beliefs using the naloxone-related risk compensation beliefs (NaRRC-B) scale. Subst Abus 2020;41:245-51.
Williams AV, Strang J, Marsden J. Development of opioid overdose knowledge (OOKS) and attitudes (OOAS) scales for take-home naloxone training evaluation. Drug Alcohol Depend 2013;132:383-6.
Hu FB, Goldberg J, Hedeker D, Flay BR, Pentz MA. Comparison of population-averaged and subject-specific approaches for analyzing repeated binary outcomes. Am J Epidemiol 1998;147:694-703.
Coffin PO, Sullivan SD. Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Ann Intern Med 2013;158:1-9.