Harm Reduction in the Field: First Responders’ Perceptions of Opioid Overdose Interventions.
Introduction: Recent policy changes in Washington State presented a unique opportunity to pair evidence-based interventions with first responder services to combat increasing opioid overdoses. However, little is known about how these interventions should be implemented. In partnership with the Resea...
| Publicado en: | Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 25; no. 4; pp. 490 - 500 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
Jul2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=178448591&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178448591 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1936900X 8B61 jtl: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health issn: 1936900X maglogo: N pubinfo: dt: Jul2024 vid: 25 iid: 4 pid: 29816 pub: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health place: Orange, California artinfo: ui: 178448591 178448591 178448591 10.5811/westjem.18033 178448591 ppf: 490 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Harm Reduction in the Field: First Responders’ Perceptions of Opioid Overdose Interventions. aug: au: Fockele, Callan Elswick Frohe, Tessa McBride, Owen Perlmutter, David L. Goh, Brenda Williams, Grover Wettemann, Courteney Holland, Nathan Finegood, Brad Oliphant-Wells, Thea Williams, Emily C. van Draanen, Jenna affil: University of Washington, Department of Emergency Medicine, Seattle, Washington. sug: subj: Harm Reduction Opiate Overdose Therapy Emergency Responders Life Experiences Substance Use Disorders Naloxone Buprenorphine HIV Infections Hepatitis C Human Male Female Young Adult Adult Middle Age Aged Funding Source Semi-Structured Interview Qualitative Studies Telemedicine Health Care Delivery, Integrated Emergency Medical Services Leaders Thematic Analysis Conceptual Framework Consensus Strategic Planning Reflexivity (Research) Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Introduction: Recent policy changes in Washington State presented a unique opportunity to pair evidence-based interventions with first responder services to combat increasing opioid overdoses. However, little is known about how these interventions should be implemented. In partnership with the Research with Expert Advisors on Drug Use team, a group of academically trained and communitytrained researchers with lived and living experience of substance use, we examined facilitators and barriers to adopting leave-behind naloxone, field-based buprenorphine initiation, and HIV and hepatitis C virus (HCV) testing for first responder programs. Methods: Our team completed semi-structured, qualitative interviews with 32 first responders, mobile integrated health staff, and emergency medical services (EMS) leaders in King County, Washington, from February-May 2022. Semi-structured interviews were recorded, transcribed, and coded using an integrated deductive and inductive thematic analysis approach grounded in community-engaged research principles. We collected data until saturation was achieved. Data collection and analysis were informed by the Consolidated Framework for Implementation Research. Two investigators coded independently until 100% consensus was reached. Results: Our thematic analysis revealed several perceived facilitators (ie, tension for change, relative advantage, and compatibility) and barriers (ie, limited adaptability, lack of evidence strength and quality, and prohibitive cost) to the adoption of these evidence-based clinical interventions for first responder systems. There was widespread support for the distribution of leave-behind naloxone, although funding was identified as a barrier. Many believed field-based initiation of buprenorphine treatment could provide a more effective response to overdose management, but there were significant concerns that this intervention could run counter to the rapid care model. Lastly, participants worried that HIV and HCV testing was inappropriate for first responders to conduct but recommended that this service be provided by mobile integrated health staff. Conclusion: These results have informed local EMS strategic planning, which will inform roll out of process improvements in King County, Washington. Future work should evaluate the impact of these interventions on the health of overdose survivors. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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