Rioux William, Viste Dylan, Sedaghat Navid, Rider Nathan, Tek Joseph Tay Wee, Perri Melissa, Schwartz David G, Ritchie Kim, Carrà Giuseppe, Carreiro Stephanie, Kreig Oona, Marcu Gabriela, Arthur Joseph, Cogdell Joanne, Brown Mike, Marshall Tyler, Ghosh S Monty
Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Drug Alcohol Rev. 2025 Jul;44(5):1430-1443. doi: 10.1111/dar.14055. Epub 2025 Apr 25.
Various novel harm reduction services leverage technology to reduce the rising number of drug poisoning deaths, particularly among those who use drugs alone. There is significant variability in terminology and outcome measures in reporting these interventions, complicating efforts to build a comprehensive knowledge base. Thus, we conducted a Delphi study to establish consensus and heterogeneity in these metrics.
Panellists from three stakeholder groups (people who use drugs, virtual harm reduction service operators and academics) participated in a multi-round Delphi study. The first round included open-ended questions to propose items in three categories: terminology, demographic information and outcomes. Subsequent rounds included options from a previously conducted scoping review for consideration. Likert ratings were used to achieve consensus, with a 70% threshold. Final rounds involved ranking terminology that reached a consensus.
Of 23 initial participants, 14 completed the fourth survey round. "Overdose response technology" was identified as the most appropriate term for these harm reduction technologies. This definition includes drug contamination alerts, overdose response hotlines and applications, wearable overdose detection technology and overdose detection tools. Fourteen demographic outcomes reached a consensus for data collection, including name or handle, neighbourhood, age, gender, past overdose experience, substance used, amount and route of use. Six service use outcomes were recommended: response type, service outcomes, morbidity and mortality, overdose events, responder arrival time and post-rescue care.
The study results are recommended to standardise terminology and guide future research and knowledge dissemination in the field, ensuring clear communication with a shared language.
各种新型减少伤害服务利用技术来减少药物中毒死亡人数的上升，特别是在那些独自使用药物的人群中。在报告这些干预措施时，术语和结果测量存在很大差异，这使得建立全面知识库的努力变得复杂。因此，我们进行了一项德尔菲研究，以在这些指标上达成共识并确定异质性。
来自三个利益相关者群体（使用药物的人、虚拟减少伤害服务运营商和学者）的小组成员参与了多轮德尔菲研究。第一轮包括开放式问题，以提出三类项目：术语、人口统计信息和结果。随后的轮次包括先前进行的范围审查中的选项以供考虑。使用李克特评分法达成共识，阈值为70%。最后一轮涉及对达成共识的术语进行排序。
在23名初始参与者中，14人完成了第四轮调查。“过量用药应对技术”被确定为这些减少伤害技术的最合适术语。该定义包括药物污染警报、过量用药应对热线和应用程序、可穿戴过量用药检测技术和过量用药检测工具。14项人口统计结果在数据收集方面达成了共识，包括姓名或称呼、社区、年龄、性别、过去的过量用药经历、使用的物质、用量和使用途径。推荐了六项服务使用结果：应对类型、服务结果、发病率和死亡率、过量用药事件、响应者到达时间和救援后护理。
建议研究结果用于规范术语，并指导该领域未来的研究和知识传播，确保用共同语言进行清晰沟通。
