Evidence map›Paper›PMID 39198758›Full record

Trial reportBMC emergency medicine2024

Take-home naloxone administered in emergency settings: feasibility of intervention implementation in a cluster randomized trial.

Helen A Snooks, Jenna K Jones, Fiona B Bell, Jonathon R Benger, Sarah L Black, Simon Dixon, Adrian Edwards, Helena Emery, Bridie A Evans, Gordon W Fuller and 11 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMC emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Helen A SnooksSwansea University, Swansea, UK. H.A.Snooks@Swansea.ac.uk.
Jenna K JonesSwansea University, Swansea, UK.
Fiona B BellYorkshire Ambulance Service, Wakefield, UK.
Jonathon R BengerUniversity of the West of England, Bristol, UK.
Sarah L BlackSouth Western Ambulance Services NHS Foundation Trust, Bristol, UK.
Simon DixonUniversity of Sheffield, Sheffield, UK.
Adrian EdwardsCardiff University, Cardiff, UK.
Helena EmerySwansea University, Swansea, UK.
Bridie A EvansSwansea University, Swansea, UK.
Gordon W FullerUniversity of Sheffield, Sheffield, UK.
Steve GoodacreUniversity of Sheffield, Sheffield, UK.
Rebecca HoskinsUniversity of the West of England, Bristol, UK.
Jane HughesUniversity of Sheffield, Sheffield, UK.
Ann JohnSwansea University, Swansea, UK.
Sasha JohnstonSouth Western Ambulance Services NHS Foundation Trust, Bristol, UK.
Matthew B JonesSwansea University, Swansea, UK.
Chris R MooreWelsh Ambulance Services NHS Trust, Cardiff, UK.
Rakshita ParabSwansea University, Swansea, UK.
Richard PilberyYorkshire Ambulance Service, Wakefield, UK.
Fiona C SampsonSouth Western Ambulance Services NHS Foundation Trust, Bristol, UK.
Alan WatkinsSwansea University, Swansea, UK.

Funding

National Institute for Health and Care Research 16/91/04
6 · The paper itself

Abstract

backgroundOpioids kill more people than any other class of drug. Naloxone is an opioid antagonist which can be distributed in kits for peer administration. We assessed the feasibility of implementing a Take-home Naloxone (THN) intervention in emergency settings, as part of designing a definitive randomised controlled trial (RCT).

methodsWe undertook a clustered RCT on sites pairing UK Emergency Departments (ED) and ambulance services. At intervention sites, we recruited emergency healthcare practitioners to supply THN to patients presenting with opioid overdose or related condition, with recruitment across 2019-2021. We assessed feasibility of intervention implementation against four predetermined progression criteria covering site sign up and staff training; identification of eligible patients; issue of THN kits and Serious Adverse Events.

resultsAt two intervention sites, randomly selected from 4, 299/687 (43.5%) clinical staff were trained (ED1 = 107, AS1 = 121, ED2 = 25, AS2 = 46). Sixty THN kits were supplied to eligible patients (21.7%) (n: ED1 = 36, AS1 = 4, ED2 = 16, AS2 = 4). Across sites, kits were not issued to eligible patients on a further 164 occasions, with reasons reported including: staff forgot (n = 136), staff too busy (n = 15), and suspected intentional overdose (n = 3), no kit available (n = 2), already given by drugs nurse (n = 4), other (n = 4). Staff recorded 626 other patients as ineligible but considered for inclusion, with reasons listed as: patient admitted to hospital (n = 194), patient absconded (n = 161) already recruited (n = 64), uncooperative or abusive (n = 55), staff not trained (n = 43), reduced consciousness level (n = 41), lack of capacity (n = 35), patient in custody (n = 21), other (n = 12). No adverse events were reported.

conclusionStaff and patient recruitment were low and varied widely by site. This feasibility study did not meet progression criteria; a fully powered RCT is not planned.

trial registrationISRCTN13232859 (Registered 16/02/2018).

Indexed as

Emergency Service, HospitalFeasibility StudiesNaloxoneNarcotic AntagonistsAdultDrug OverdoseFemaleHumansMaleMiddle AgedOpiate OverdoseUnited KingdomNaloxoneNarcotic AntagonistsEmergency medical servicesFeasibility studyNaloxoneOpioid-Related DisordersRandomised controlled trial

Identifiers

PMID39198758
PMCPMC11360782

What OpenQuestion holds

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Registered trials

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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.