Feasibility and acceptability of inserts promoting virtual overdose monitoring services (VOMS) in naloxone kits: a qualitative study

Abstract

Background In response to the ongoing opioid epidemic, there have been efforts to develop novel harm reduction strategies alongside scaling of currently implemented programs. Virtual overdose monitoring services (VOMS) are a novel intervention which aims to reduce substance-related mortality through technology for those who are out of reach of current supervised consumption sites. Scaling of naloxone programs presents a unique opportunity to promote VOMS to people at risk of substance-related mortality. This study aims to explore the feasibility and acceptability of naloxone kit inserts in promoting awareness of VOMS. Method We used purposive and snowball sampling to recruit 52 key informants, including people who use drugs (PWUD) with experience using VOMS (n = 16), PWUD with no prior experience using VOMS (n = 9), family members of PWUD (n = 5), healthcare and emergency services professionals (n = 10), community-based harm reduction organizations (n = 6), and VOMS administrators/peer support workers (n = 6). Two evaluators completed semi-structured interviews. Interview transcripts were analyzed using thematic analysis informed to identify key themes. Results Four key interrelated themes emerged, including the acceptability of naloxone kit inserts to promote VOMS, best practices for implementation, key messaging to include within promotional materials and facilitators to dissemination of harm reduction material. Participants highlighted that messaging should be promoted both inside and outside the kits, should be concise, provide basic information about VOMS and can be facilitated through current distribution streams. Messaging could further be used to draw attention to local harm reduction services and could be promoted on other supplies, including lighters and safer consumption supplies. Conclusion Findings demonstrate that it is acceptable to promote VOMS within naloxone kits and highlight interviewees preferred ways to do so. Key themes that emerged from interviewees can be used to inform the dissemination of harm reduction information, including VOMS and bolster current strategies for reducing illicit drug overdose.

Implementing Canada’s first national virtual phone based overdose prevention service: lessons learned from creating the National Overdose Response Service (NORS)

“…Initial attempts to advertise NORS included TV advertisements and radio ads, social media advertising and engagement along with merchandise distribution. NORS’ greatest success however came from the attendance at various public events, training around naloxone kit usage, and messaging on not using alone [ 37 ]. Presentations and conferences were used within the scientific community to create further exposure and understanding of the service.…”

Perspectives of Canadian Healthcare and Harm Reduction Workers on Mobile Overdose Response Services: A Qualitative Study

“…17,18 Operators from hotline-based MORS like NORS have begun to offer mental health support and psychosis de-escalation to clients. 34 However, a few respondents indicated that MORS could increase the number of ambulance calls and potentially overwhelm the current capacity of the healthcare system. Overall, the authors believe that MORS can be leveraged to refer PWUS to more formal and reliable mental health supports, which may deter unnecessary involvement of emergency services.…”

A cost benefit analysis of a virtual overdose monitoring service/mobile overdose response service: the national overdose response service

“…Furthermore, increased uptake of these services would likely result in an increase in the cost-benefit of these interventions. As a result, novel strategies to promote these services among people who use drugs such as the use of messaging on naloxone kits [ 42 ] or other public health dissemination strategies should be utilized to extend the reach of these harm-reduction services. An enhanced economic evaluation looking at improvements in quality of life, a more in-depth analysis of EMS call-outs, hospital admissions, social service referrals, and disease/presentation severity scores for hospital evaluations, could help further enhance the findings of this study.…”