Beauchamp Gillian A, Cuadrado Hoonani M, Campbell Seth, Eliason Bennie B, Jones Chase L, Fedor Aaron T, Grantz Lauren, Roth Paige, Greenberg Marna Rayl
Emergency and Hospital Medicine, Lehigh Valley Health Network Campus/University of South Florida Morsani College of Medicine, Allentown, USA.
Street Medicine, Lehigh Valley Health Network Campus/University of South Florida Morsani College of Medicine, Allentown, USA.
Cureus. 2021 Nov 23;13(11):e19831. doi: 10.7759/cureus.19831. eCollection 2021 Nov.
The use of naloxone to reverse a potentially fatal opioid overdose is a harm reduction strategy that reduces mortality and increases the potential for referral to substance use treatment for affected individuals. In the setting of outreach performed by a street medicine team, we aimed to determine the effectiveness of an educational intervention involving distribution of naloxone accompanied by a brief instructive session about opioids, opioid overdose, and medication administration.
Our street medicine outreach team distributed 200 naloxone kits to clinicians and volunteers involved in caring for patients on 'street rounds,' as well as in shelters, soup kitchens, and street medicine clinic settings. Those receiving a naloxone kit engaged in a peer-reviewed presentation on how to safely use the medication to reverse a potentially fatal opioid overdose. The study team developed and administered a pre- and post-survey of 10 multiple choice questions on material covered in the educational training. The pre- and post-survey scores were compared to assess the effectiveness of implementing this training. Results were stratified by participant gender and age group.
Out of the 200 participants, six were excluded from the analysis due to completely missing data from one or both surveys. The mean age of participants was 40.2±12.5 years; 120 (65.6%) were female, 62 (33.9%) were male, and 1 (0.6%) identified as nonbinary. Every survey question had an increase in correct responses from pre-survey to post-survey (identified by an increase in the percentage of correct responses). The mean survey total score increased from 5.5±1.6 to 7.5±1.3. Within the sample of 194, the mean difference in scores from pre-survey to post-survey was 2.02 points (95% CI [1.77, 2.26]), p<0.0001. Males had a mean increase in the total score from 5.6±1.8 to 7.4±1.1. Females had a mean increase in the total score from 5.5±1.5 to 7.5±1.3. The difference in total scores in males was 1.89 points (95% CI [1.42, 2.35]), p<0.0001, and in females was 2.02 points (95% CI [1.71, 2.32]), p<0.0001. Post-test scores improved in all age groups.
The educational training on opioids, opioid overdose, and the use of naloxone was an effective adjunct to naloxone kit distribution to volunteers and clinicians caring for people experiencing homelessness.
使用纳洛酮来逆转潜在致命的阿片类药物过量是一种减少伤害的策略,可降低死亡率,并增加为受影响个体转介接受物质使用治疗的可能性。在街头医疗团队开展外展服务的背景下,我们旨在确定一项教育干预措施的有效性,该措施包括分发纳洛酮并附带一场关于阿片类药物、阿片类药物过量及药物给药的简短指导课程。
我们的街头医疗外展团队向参与在“街头巡诊”中照顾患者的临床医生和志愿者,以及收容所、施粥处和街头医疗诊所环境中的人员分发了200个纳洛酮试剂盒。那些收到纳洛酮试剂盒的人参加了一场经过同行评审的关于如何安全使用该药物来逆转潜在致命阿片类药物过量的讲座。研究团队编制并实施了一项包含10道多项选择题的前后调查,内容涉及教育培训中涵盖的材料。比较前后调查得分以评估实施该培训的有效性。结果按参与者性别和年龄组进行分层。
在200名参与者中,有6人因一份或两份调查的数据完全缺失而被排除在分析之外。参与者的平均年龄为40.2±12.5岁;120人(65.6%)为女性,62人(33.9%)为男性,1人(0.6%)认定为非二元性别。从调查前到调查后,每个调查问题的正确回答都有所增加(通过正确回答百分比的增加来确定)。调查总分平均值从5.5±1.6提高到7.5±1.3。在194人的样本中,调查前到调查后的得分平均差异为2.02分(95%置信区间[1.77, 2.26]),p<0.0001。男性的总分平均值从5.6±1.8提高到7.4±1.1。女性的总分平均值从5.5±1.5提高到7.5±1.3。男性的总分差异为1.89分(95%置信区间[1.42, 2.35]),p<0.0001,女性为2.02分(95%置信区间[1.71, 2.32]),p<0.0001。所有年龄组的测试后得分均有所提高。
关于阿片类药物、阿片类药物过量及纳洛酮使用的教育培训是向照顾无家可归者的志愿者和临床医生分发纳洛酮试剂盒的有效辅助手段。