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

Abstract

AbstractAimsTo 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.DesignSystematic literature review.Data SourcesCochrane, 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.Review MethodsA systematic literature review focused on qualitative studies and quantitative survey designs. Synthesis without meta‐analysis was undertaken using a thematic analysis approach.ResultsSeven 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.ConclusionTake‐home naloxone is a vital harm reduction initiative. However, barriers exist that prevent the optimum implementation of these initiatives.ImpactWhat 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. What this paper adds: 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. Reporting MethodThis has adhered to the PRISMA reporting guidelines for systematic reviews.Patient or Public ContributionNo patient or public contribution.