Ambrose Graham, Amlani Ashraf, Buxton Jane A
Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
BMJ Open. 2016 Jun 21;6(6):e011224. doi: 10.1136/bmjopen-2016-011224.
This study sought to identify factors that may be associated with help-seeking by witnesses during overdoses where naloxone is administered.
Overdose events occurred in and were reported from the five regional health authorities across British Columbia, Canada. Naloxone administration forms completed following overdose events were submitted to the British Columbia Take Home Naloxone programme.
All 182 reported naloxone administration events, reported by adult men and women and occurring between 31 August 2012 and 31 March 2015, were considered for inclusion in the analysis. Of these, 18 were excluded: 10 events which were reported by the person who overdosed, and 8 events for which completed forms did not indicate whether or not emergency medical help was sought.
Seeking emergency medical help (calling 911), as reported by participants, was the sole outcome measure of this analysis.
Medical help was sought (emergency services-911 called) in 89 (54.3%) of 164 overdoses where naloxone was administered. The majority of administration events occurred in private residences (50.6%) and on the street (23.4%), where reported rates of calling 911 were 27.5% and 81.1%, respectively. Overdoses occurring on the street (compared to private residence) were significantly associated with higher odds of calling 911 in multivariate analysis (OR=10.68; 95% CI 2.83 to 51.87; p<0.01), after adjusting for other variables.
Overdoses occurring on the street were associated with higher odds of seeking emergency medical help by responders. Further research is needed to determine if sex and stimulant use by the person who overdosed are associated with seeking emergency medical help. The results of this study will inform interventions within the British Columbia Take Home Naloxone programme and other jurisdictions to encourage seeking emergency medical help.
本研究旨在确定在使用纳洛酮的过量用药事件中，可能与目击者寻求帮助相关的因素。
过量用药事件发生在加拿大不列颠哥伦比亚省的五个地区卫生当局，并由其报告。过量用药事件后填写的纳洛酮使用表格提交给了不列颠哥伦比亚省带回家纳洛酮计划。
2012年8月31日至2015年3月31日期间，成年男性和女性报告的所有182起纳洛酮使用事件均被纳入分析。其中，18起被排除：10起是过量用药者本人报告的事件，8起是填写完整的表格未表明是否寻求了紧急医疗帮助的事件。
参与者报告的寻求紧急医疗帮助（拨打911）是本分析的唯一结局指标。
在164起使用纳洛酮的过量用药事件中，有89起（54.3%）寻求了医疗帮助（拨打了紧急服务电话911）。大多数用药事件发生在私人住宅（50.6%）和街道（23.4%），报告的拨打911的比例分别为27.5%和81.1%。在多变量分析中，在校正其他变量后，与私人住宅相比，发生在街道上的过量用药事件与拨打911的较高几率显著相关（OR=10.68；95%CI 2.83至51.87；p<0.01）。
发生在街道上的过量用药事件与救援者寻求紧急医疗帮助的较高几率相关。需要进一步研究以确定过量用药者的性别和是否使用兴奋剂与寻求紧急医疗帮助是否相关。本研究结果将为不列颠哥伦比亚省带回家纳洛酮计划及其他司法管辖区内鼓励寻求紧急医疗帮助的干预措施提供参考。
