Evidence map›Paper›PMID 26642424›Full record

ArticleAddiction (Abingdon, England)2016

Effectiveness of Scotland's National Naloxone Programme for reducing opioid-related deaths: a before (2006-10) versus after (2011-13) comparison.

Sheila M Bird, Andrew McAuley, Samantha Perry, Carole Hunter

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Addiction (Abingdon, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 135 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
135citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

135 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

75 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Sheila M BirdMRC Biostatistics Unit, Cambridge, UK.
Andrew McAuleyNHS Health Scotland, Public Health Science Directorate, Glasgow, UK.
Samantha PerryEmergency Department, Western Infirmary, Glasgow, UK.
Carole HunterAddiction Services for NHS Greater Glasgow and Clyde, Possilpark Health and Care Centre, Glasgow, UK.

Funding

Medical Research Council MC_U105260794Medical Research Council MC_UU_12023/30
6 · The paper itself

Abstract

aimsTo assess the effectiveness for Scotland's National Naloxone Programme (NNP) by comparison between 2006-10 (before) and 2011-13 (after NNP started in January 2011) and to assess cost-effectiveness.

designThis was a pre-post evaluation of a national policy. Cost-effectiveness was assessed by prescription costs against life-years gained per opioid-related death (ORD) averted.

settingScotland, in community settings and all prisons.

interventionBrief training and standardized naloxone supply became available to individuals at risk of opioid overdose. MEASUREMENTS: ORDs as identified by National Records of Scotland. Look-back determined the proportion of ORDs who, in the 4 weeks before ORD, had been (i) released from prison (primary outcome) and (ii) released from prison or discharged from hospital (secondary). We report 95% confidence intervals for effectiveness in reducing the primary (and secondary) outcome in 2011-13 versus 2006-10. Prescription costs were assessed against 1 or 10 life-years gained per averted ORD.

findingsIn 2006-10, 9.8% of ORDs (193 of 1970) were in people released from prison within 4 weeks of death, whereas only 6.3% of ORDs in 2011-13 followed prison release (76 of 1212, P < 0.001; this represented a difference of 3.5% [95% confidence interval (CI) = 1.6-5.4%)]. This reduction in the proportion of prison release ORDs translates into 42 fewer prison release ORDs (95% CI = 19-65) during 2011-13, when 12,000 naloxone kits were issued at current prescription cost of £225,000. Scotland's secondary outcome reduced from 19.0 to 14.9%, a difference of 4.1% (95% CI = 1.4-6.7%).

conclusionsScotland's National Naloxone Programme, which started in 2011, was associated with a 36% reduction in the proportion of opioid-related deaths that occurred in the 4 weeks following release from prison.

Indexed as

AdultAgedAnalgesics, OpioidCost-Benefit AnalysisFemaleHumansMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPrisonersScotlandTreatment OutcomeAnalgesics, OpioidNaloxoneNarcotic AntagonistsBefore/after policy evaluationcausalityeffectivenessnational naloxone programmeopioid-related deathsprison release opioid-related deathsstatistical powertake-home naloxone

Identifiers

PMID26642424
PMCPMC4982071

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.