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  • PP25 The take home naloxone intervention multicentre emergency setting feasibility (TIME) trial: an early perspective from one UK ambulance service

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PP25 The take home naloxone intervention multicentre emergency setting feasibility (TIME) trial: an early perspective from one UK ambulance service
  1. Sasha Johnston1,
  2. Helen Snooks2,
  3. Jenna Jones2,
  4. Fiona Bell3,
  5. Jonathan Benger4,
  6. Sarah Black1,
  7. Simon Dixon5,
  8. Adrian Edwards6,
  9. Bridie Evans2,
  10. Gordon Fuller5,
  11. Steve Goodacre5,
  12. Rebecca Hoskins4,
  13. Ann John2,
  14. Barbara Lawrence7,
  15. Chris Moore8,
  16. Emma Parry7,
  17. Kelly Hird3,
  18. Sarah Wait9,
  19. Alan Watkins2
  1. 1South Western Ambulance Services NHS Foundation Trust, UK
  2. 2Swansea University, UK
  3. 3Yorkshire Ambulance Service, UK
  4. 4University of the West of England, Bristol, UK
  5. 5University of Sheffield, UK
  6. 6Cardiff University, UK
  7. 7Patient and Public Representative
  8. 8Welsh Ambulance Services NHS Trust, UK
  9. 9University Hospitals Bristol NHS Foundation Trust, UK

Abstract

Background Drug poisoning deaths in England and Wales have increased by 52% since 2011 with over half involving opioids. Deaths are preventable if naloxone is administered in time. Take Home Naloxone (THN) kits have been distributed through drug services; however, uptake is low and effectiveness unproven. The TIME trial tests the feasibility of conducting a full randomised controlled trial of providing THN administration and basic life support training to high-risk opioid-users in emergency care settings.

Methods A multi-site feasibility trial commenced in June 2019 with two hospitals and their surrounding ambulance services (Bristol Royal Infirmary (BRI) with South Western Ambulance NHS Foundation Trust (SWASFT) and Hull Royal Infirmary with Yorkshire Ambulance Service) randomly allocated to intervention arms; and sites in Wrexham and Sheffield allocated as ‘usual care’ controls. SWASFT began recruiting in October 2019 with the aim of recruiting and training 50% (n=111) of paramedics working within the BRI’s catchment area, to supply THN to at least 100 eligible patients during a 12-month period.

Results The trial was suspended between 17.03.2020-06.08.2020 and extended to 01.03.2021 (COVID-19). Despite this, 121 SWASFT paramedics undertook TIME training. TIME trained paramedics attended 30% (n=57) of the n=190 opioid-related emergency calls requiring naloxone administration during the study period. A total of n=29 potentially eligible patients were identified before and n=28 after the COVID-19 suspension. Two patients were supplied with THN during each period. During the COVID-19 suspension, twenty-two potentially eligible patients were missed. The majority of eligible patients presented with a reduced consciousness level, preventing recruitment (73%; n=42/48). These patients were transported to hospital for further treatment (n=39) or died on scene following advanced life support (n=3).

Conclusions The lowered consciousness levels of prehospital emergency ambulance patients who present with opioid poisoning, often prevent the delivery of training required to enable the supply of THN.

https://doi.org/10.1136/emermed-2021-999.25

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