A systematic review exploring healthcare professionals' perceptions of take-home naloxone dispensing in acute care areas.

Osinski, Karen; Afseth, Janyne

Abstract

To explore healthcare professionals' perceptions and experiences of take-home naloxone initiatives in acute care settings to gain an understanding of issues facilitating or impeding dispensing. Systematic literature review. Cochrane, MEDLINE and CINAHL were searched from 15/03/2021 to 18/03/2021, with a follow-up search performed via PubMed on 22/03/2021. The years 2011 to 2021 were included in the search. A systematic literature review focused on qualitative studies and quantitative survey designs. Synthesis without meta-analysis was undertaken using a thematic analysis approach. Seven articles from the United States of America (5), Australia (1) and Canada (1) with 750 participants were included in the review. Results indicate ongoing stigma towards people who use drugs with preconceived moral concerns regarding take-home naloxone. There was confusion regarding roles and responsibilities in take-home naloxone dispensing and patient education. Similarly, there was a lack of clarity over logistical and financial issues. Take-home naloxone is a vital harm reduction initiative. However, barriers exist that prevent the optimum implementation of these initiatives. What is already known: Deaths due to opioid overdose are a global health concern, with take-home naloxone emerging as a key harm reduction scheme. Globally, less than 10% of people who use drugs have access to treatment initiatives, including take-home naloxone. An optimum point of distribution of take-home naloxone is post-acute hospital care. There is role confusion regarding responsibility for the provision of take-home naloxone and patient education. This is exacerbated by inconsistent provision of training and education for healthcare professionals. Logistical or financial concerns are common and moral issues are prevalent with some healthcare professionals questioning the ethics of providing take-home naloxone. Stigma towards people who use drugs remains evident in some acute care areas which may impact the use of this intervention. Implications for practice/policy: Further primary research should examine what training and education methods are effective in improving the distribution of take-home naloxone in acute care. Education should focus on reduction of stigma towards people who use drugs to improve the distribution of take-home naloxone. Standardized care guidelines may ensure interventions are offered equally and take-home naloxone 'champions' could drive initiatives forward, with support from harm reduction specialists. This has adhered to the PRISMA reporting guidelines for systematic reviews. No patient or public contribution.

Citation

OSINSKI, K. and AFSETH, J. 2024. A systematic review exploring healthcare professionals' perceptions of take-home naloxone dispensing in acute care areas. Journal of advanced nursing [online], 80(11), pages 4361-4371. Available from: https://doi.org/10.1111/jan.16181

• Journal Article Type: Review
• Acceptance Date: Mar 20, 2024
• Online Publication Date: Apr 2, 2024
• Publication Date: Nov 30, 2024
• Deposit Date: May 24, 2024
• Publicly Available Date: Apr 3, 2025
• Journal: Journal of advanced nursing
• Print ISSN: 0309-2402
• Electronic ISSN: 1365-2648
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 80
• Issue: 11
• Pages: 4361-4371
• DOI: https://doi.org/10.1111/jan.16181
• Keywords: Healthcare professionals; Take‐home naloxone; Harm reduction; Literature review; Systematic review; Nursing; Opioid overdose
• Public URL: https://rgu-repository.worktribe.com/output/2307600
• Related Public URLs: https://rgu-repository.worktribe.com/output/2541630 [Protocol]
• Additional Information: This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.