title: Development and process evaluation of an educational intervention for overdose prevention and naloxone distribution by general practice trainees.
abstract: BACKGROUND
  Overdose is the most common cause of fatalities among opioid users. Naloxone is a life-saving medication for reversing opioid overdose. In Ireland, it is currently available to ambulance and emergency care services, but General Practitioners (GP) are in regular contact with opioid users and their families. This positions them to provide naloxone themselves or to instruct patients how to use it. The new Clinical Practice Guidelines of the Pre-hospital Emergency Care Council of Ireland allows trained bystanders to administer intranasal naloxone. We describe the development and process evaluation of an educational intervention, designed to help GP trainees identify and manage opioid overdose with intranasal naloxone.
  
  
  METHODS
  Participants (N = 23) from one postgraduate training scheme in Ireland participated in a one-hour training session. The repeated-measures design, using the validated Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales, examined changes immediately after training. Acceptability and satisfaction with training were measured with a self-administered questionnaire.
  
  
  RESULTS
  Knowledge of the risks of overdose and appropriate actions to be taken increased significantly post-training [OOKS mean difference, 3.52 (standard deviation 4.45); P < 0.001]; attitudes improved too [OOAS mean difference, 11.13 (SD 6.38); P < 0.001]. The most and least useful delivery methods were simulation and video, respectively.
  
  
  CONCLUSIONS
  Appropriate training is a key requirement for the distribution of naloxone through general practice. In future studies, the knowledge from this pilot will be used to inform a train-the-trainer model, whereby healthcare professionals and other front-line service providers will be trained to instruct opioid users and their families in overdose prevention and naloxone use.
authors.affiliation: Centre for Emergency Medical Science, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. jan.klimas@ucd.ie.|British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada. jan.klimas@ucd.ie.|c/o Coombe Family Practice, Dolphins barn, Dublin, Ireland. jan.klimas@ucd.ie.
authors.forename: Jan
authors.initials: J
authors.lastname: Klimas
authors.affiliation: Centre for Emergency Medical Science, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. mairead.egan@ucd.ie.
authors.forename: Mairead
authors.initials: M
authors.lastname: Egan
authors.affiliation: Centre for Emergency Medical Science, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. helen.tobin@ucd.ie.
authors.forename: Helen
authors.initials: H
authors.lastname: Tobin
authors.affiliation: Centre for Emergency Medical Science, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. neil.coleman@ucd.ie.
authors.forename: Neil
authors.initials: N
authors.lastname: Coleman
authors.affiliation: Centre for Emergency Medical Science, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. gerard.bury@ucd.ie.
authors.forename: Gerard
authors.initials: G
authors.lastname: Bury
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D017028:Caregivers / Q000193:education*; D062787:Drug Overdose / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D004503:Education, Medical, Graduate; D005190:Family; D005240:Feasibility Studies; D005260:Female; D033062:Friends; D058006:General Practice / Q000193:education*; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland; D008297:Male; D009270:Naloxone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000188:drug therapy*; D010865:Pilot Projects; D015397:Program Evaluation
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone