Dos Santos Bruna, Farzan Nipun Rifat, Maria Subic Anna, Kubica Alexandra, Rondinelli Nick, Marentette Don, Muise Joanna, Paes Kevin, Riley Meghan, Bhuiya Samiya, Crosby Jeannene, McBride Keely, Salter Joe, Orkin Aaron M
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Heart to Heart First Aid CPR Services Inc., Toronto, Canada.
PLOS Digit Health. 2024 Jun 7;3(6):e0000412. doi: 10.1371/journal.pdig.0000412. eCollection 2024 Jun.
The global opioid poisoning crisis is a complex issue with far-reaching public health implications. Opioid Poisoning Education and Naloxone Distribution (OPEND) programs aim to reduce stigma and promote harm reduction strategies, enhancing participants' ability to apply life-saving interventions, including naloxone administration and cardiopulmonary resuscitation (CPR) to opioid poisoning. While virtual OPEND programs have shown promise in improving knowledge about opioid poisoning response, their implementation and evaluation have been limited. The COVID-19 pandemic has sparked renewed interest in virtual health services, including OPEND programs. Our study reviews the literature on fully virtual OPEND programs worldwide. We analyzed 7,722 articles, 30 of which met our inclusion criteria. We extracted and synthesized information about the interventions' type, content, duration, the scales used, and key findings. Our search shows a diversity of interventions being implemented, with different study designs, duration, outcomes, scales, and different time points for measurement, all of which hinder a meaningful analysis of interventions' effectiveness. Despite this, virtual OPEND programs appear effective in increasing knowledge, confidence, and preparedness to respond to opioid poisoning while improving stigma regarding people who use opioids. This effect appears to be true in a wide variety of populations but is significantly relevant when focused on laypersons. Despite increasing efforts, access remains an issue, with most interventions addressing White people in urban areas. Our findings offer valuable insights for the design, implementation, and evaluation of future virtual OPEND programs.
全球阿片类药物中毒危机是一个复杂的问题,具有深远的公共卫生影响。阿片类药物中毒教育与纳洛酮分发(OPEND)项目旨在减少污名化并推广减少伤害策略,提高参与者应用救生干预措施的能力,包括对阿片类药物中毒进行纳洛酮给药和心肺复苏(CPR)。虽然虚拟OPEND项目在提高对阿片类药物中毒应对的认识方面已显示出前景,但其实施和评估一直有限。新冠疫情引发了对包括OPEND项目在内的虚拟健康服务的新兴趣。我们的研究回顾了全球范围内关于完全虚拟OPEND项目的文献。我们分析了7722篇文章,其中30篇符合我们的纳入标准。我们提取并综合了有关干预措施的类型、内容、持续时间、使用的量表以及主要发现的信息。我们的搜索显示正在实施的干预措施多种多样,具有不同的研究设计、持续时间、结果、量表以及不同的测量时间点,所有这些都阻碍了对干预措施有效性进行有意义的分析。尽管如此,虚拟OPEND项目似乎在增加对阿片类药物中毒应对的知识、信心和准备程度方面有效,同时改善了对使用阿片类药物者的污名化。这种效果在各种各样的人群中似乎都是如此,但在关注非专业人员时尤为显著。尽管付出了越来越多的努力,但获取机会仍然是一个问题,大多数干预措施针对的是城市地区的白人。我们的研究结果为未来虚拟OPEND项目的设计、实施和评估提供了宝贵的见解。