"Take Home" Naloxone (THN)

PARAMEDIC SUPPLIED "TAKE HOME" NALOXONE: A RANDOMISED FEASIBILITY STUDY: Introduction

"Take Home" Naloxone (THN) kits for use in the event of an opioid overdose may reduce further overdose and deaths, but distribution through Drugs Services may not reach those at highest risk. Attendance by paramedics at emergency calls for opioid overdose presents an opportunity to distribute THN kits. This feasibility study will assess the acceptability of THN, and gather data to inform definitive trial planning.

Methods and analysis

Cluster randomised trial with staggered allocation of paramedics (clusters) to groups. Paramedics in an urban area of south Wales, UK were invited to take part and randomly allocated to training. Patients attended by trained paramedics and issued THN kits fell into the intervention group. Patients attended by paramedics following usual practice (until they received their training) fell into the control group. We will gather data about processes and outcomes of care: numbers of patients eligible for intervention, offered and accepted THN, attended Emergency Department, suffered further overdose, died within 12 months; and about follow up rates: numbers of patients consented, completed questionnaire (postal or telephone). We will gather qualitative data about acceptability to patients and paramedics through interviews and focus groups.

Preliminary findings (unvalidated data)

85 of 102 eligible paramedics took part. The number of opioid related EMS contacts (n=215), exceeded the number predicted (100–120) for the 12-months period. Of the 182 cases attended by study paramedics, 148 were attended by trained paramedics. 35 of the 55 patients eligible for the intervention were offered it. 25 accepted the intervention, received training and a THN kit. As anticipated, follow-up of participants proved challenging. Of the 215 events for which we have data, 58 were repeat episodes involving 25 individual users. The number of repeat encounters experienced by these individuals ranged from 2 to 5. Six deaths were recorded during the study period.



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