Web applications for training in the use of naloxone nasal ...€¦ · Web applications for...

Web applications for training in the

use of naloxone nasal spray to

prevent opioid overdoses

Desiree Madah-Amiri, PhD

Norwegian Centre for Addiction Research

LAR conference, October 2018

Background

• What is naloxone?

• What is take home naloxone?

• How has it been implemented in Norway

• Why the need for web applications?

• What digital platforms are now being used

Naloxone

• Antidote to an opioid overdose

• Take-home naloxone

– administered before ambulance arrives

• Training

– Prevention, recognition, response

Take-home naloxone in Norway

National overdose prevention strategy in 2014

– Pilot in Oslo & Bergen

– Funding provided

– Prescription-free

– Intranasal device

57

8 74

4 9

80

13

46

15

1

58

3 80

3

11

83

72

9

13

27

17

83

25

29

2014 2015 2016 2017

INITIAL AND REFILL NALOXONE DISTRIBUTED 2014-2017

Initial Refill Total

By first quarter 2018: 7000

Distribution centers

100 different distribution sites throughout 29 municipalities

Expansion

15 new in 2018

Over 29 municipalities

75% coverage of OD locations

2018

Fredrikstad

Bodø

Tromsø

Skien

Porsgrund

Tønsberg

Arendal

2017

Drammen

Asker

Stavanger

Sandnes

Trondheim

2016

Oslo

Bergen

2014

• Expansion meant needing to re-evaluate

how we were operating

• Current methods somewhat unsustainable

Training

User

5-10 minutes

Risk factors

Prevention

Recognition

Response

Staff

2 hours

Staff able to then train users

Staff training

Staff from existing low-threshold centers

• Train-the-trainer model

– Began with 3 central trainers

– >500 staff trained in first 18 months

– Currently over 1200

Madah-Amiri, Clausen, & Lobmaier. Drug alcohol depend. 2016

While successful, not sustainable…

…Naloxone had to modernize and adapt

E-learning

E-learning

Background

• Overdoses

• Naloxone program

• Opioids

• Naloxone

Curriculum

• Risk factors

• Recognition

• Response

• HLR

Documentation

• Initial forms

• Refill forms

• Nettskjema

Other

• Debriefing

• Considerations

• Ideas for implemntation

Questions throughout, final quiz, certification

Online data collection

Training

User

5-10 minutes

Risk factors

Prevention

Recognition

Response

Staff

2 hours

Staff able to then train users

Instructional video

https://vimeo.com/276069515/78e83dd2bb

www.stoppoverdose.no

Acknowledgements Naloxone ninjas

Åse Merete Solheim (Bergen)

Øystein Bruun Ericson (Oslo)

Vibeke Kleveland (Trondheim)

Julie Høivik

SERAF

Philipp Lobmaier (MD, PhD)

Thomas Clausen (professor, PI)

Pharmaceutical industry (DnE)

Jenny Teigene and colleagues

Directorate of Health

Martin Blindheim

Ambulance services

Guttorm Brattebø (Bergen), Arne Skulberg (Oslo), and colleagues