Development and process evaluation of an educational intervention for overdose prevention and naloxone distribution by general practice trainees

Abstract

BackgroundOverdose is the most common cause of fatalities among opioid users. Naloxone is a life-saving medication for reversing opioid overdose. In Ireland, it is currently available to ambulance and emergency care services, but General Practitioners (GP) are in regular contact with opioid users and their families. This positions them to provide naloxone themselves or to instruct patients how to use it. The new Clinical Practice Guidelines of the Pre-hospital Emergency Care Council of Ireland allows trained bystanders to administer intranasal naloxone.We describe the development and process evaluation of an educational intervention, designed to help GP trainees identify and manage opioid overdose with intranasal naloxone.MethodsParticipants (N = 23) from one postgraduate training scheme in Ireland participated in a one-hour training session. The repeated-measures design, using the validated Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales, examined changes immediately after training. Acceptability and satisfaction with training were measured with a self-administered questionnaire.ResultsKnowledge of the risks of overdose and appropriate actions to be taken increased significantly post-training [OOKS mean difference, 3.52 (standard deviation 4.45); P < 0.001]; attitudes improved too [OOAS mean difference, 11.13 (SD 6.38); P < 0.001]. The most and least useful delivery methods were simulation and video, respectively.ConclusionAppropriate training is a key requirement for the distribution of naloxone through general practice. In future studies, the knowledge from this pilot will be used to inform a train-the-trainer model, whereby healthcare professionals and other front-line service providers will be trained to instruct opioid users and their families in overdose prevention and naloxone use.

Opiate addiction and overdose: experiences, attitudes, and appetite for community naloxone provision

“…The study instrument was informed by previous studies concerning the epidemiology of opiate overdose and a pilot evaluation of an educational session to support overdose prevention and naloxone distribution by GP trainees. 22,23 It included sections on demographics and practice profile, as well as questions relating to experience of and attitudes toward problem opiate use, overdose, and naloxone treatment. Data were analysed using Microsoft Excel (2013) and IBM SPSS (version 20).…”

Overdose prevention training with naloxone distribution in a prison in Oslo, Norway: a preliminary study

“…The majority of opioid overdoses occur within 1 to 3 h after injecting [ 16 ]. This window provides a chance to intervene if adequate training has been received beforehand [ 17 – 19 ]. Opioid overdose prevention trainings can significantly increase accurate recognition of an opioid overdose and equip those trained with the responses needed to prevent death [ 18 , 20 ].…”

Opiate use disorders and overdose: Medical students' experiences, satisfaction with learning, and attitudes toward community naloxone provision

“…The development of the study instrument was informed by a prior epidemiological study of opioid overdose in Dublin, by an evaluation of an educational intervention for overdose prevention and naloxone distribution among GP trainees (28,29) and by a modified version of the instrument used previously by this group to examine general practitioners' (GP) and GP trainees' experiences and attitudes toward opioid use disorder and overdose (8,9). The survey consisted of 11 questions on demographics, experience of and attitudes toward opioid use disorder and naloxone distribution, and perceived competence to recognise, assess and manage opioid use disorder, using a five point scale (1 = strongly disagree, 5 = strongly agree).…”