SOONER Feasibility Study Protocol
- Conditions
- Overdose
- Interventions
- Behavioral: SOONER Training and Naloxone Kit KitBehavioral: Community or Hospital-Based Training
- Registration Number
- NCT03821649
- Lead Sponsor
- Unity Health Toronto
- Brief Summary
Opioid Overdose Education and Naloxone Distribution programs (OEND) involve training and equipping people who are likely to be bystanders to opioid overdose to recognize and respond to opioid-related emergencies by activating emergency services, delivering basic life support and administering naloxone. The goal of the Surviving Opioid Overdose with Naloxone Education and Resuscitation (SOONER) trial is to identify if point-of-care OEND increases rates of satisfactory bystander resuscitative performance to simulated opioid overdose in comparison with the existing standard of care. Recruitment and retention of participants at risk of overdose, and the acceptability of the simulated overdose outcome may challenge the feasibility of the SOONER trial. The primary objective is to identify if an integrated participant recruitment and retention strategy can recruit approximately 28 eligible participants within 4 weeks and maintain less than 50% attrition in the context of a randomized trial on point-of-care OEND and simulated overdose resuscitation performance in family practice, emergency department, and addictions settings in Toronto, Ontario. After the initial 28 participants, we are continuing to recruit up to 50 more participants in a bridging phase that leads into the full trial.
- Detailed Description
Deaths from opioid overdose represent an important and expanding global public health epidemic. Opioid Overdose Education and Naloxone Distribution programs (OEND) involve training and equipping people who are likely to witness overdose to recognize these emergencies and administer essential first aid interventions including naloxone, a widely known and effective competitive opioid antagonist. Policymakers and practitioners have called for expanded access to OEND programs in clinical settings such as emergency departments, family practice, and addiction medicine clinics, or "point-of-care OEND". Point-of-care OEND would improve access to this potentially life-saving intervention. Simple and effective point-of-care OEND tools are a prerequisite for the successful translation of this intervention into general ambulatory settings, including family practice, addiction medicine and psychiatry clinics, and emergency departments. The investigators plan to conduct a randomized trial to evaluate the educational effectiveness of a novel point-of-care OEND kit in a simulated opioid overdose, in comparison with existing community- and hospital-based OEND programs.
Conducting trials among people who use drugs or who are likely to witness overdose involves several well-documented scientific, logistical, and bioethical challenges. These challenges contribute to the persistent under-evaluation of interventions to enhance the health of this marginalized population, and threats to study validity when retention rates are low.
Recruitment, retention and attrition rates could alter the study timelines, logistics and costs for the proposed trial. A feasibility study is needed to evaluate and refine an integrated participant recruitment and retention strategy, develop expected retention rates, establish the local acceptability of study procedures in recruitment sites, and reconsider study design and analysis if required. A feasibility study will also permit the evaluation of basic randomization and data collection procedures.
The primary objective of this feasibility study is to identify if an integrated participant recruitment and retention strategy can recruit approximately 28 eligible participants within 4 weeks and maintain less than 50% attrition in the context of a randomized trial on point-of-care OEND and simulated overdose resuscitation performance in family practice, emergency department, and addiction medicine settings at St. Michael's Hospital, and in family practice at the Inner City Family Health Team.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 90
Not provided
Participants are ineligible by meeting any one or more of the following:
- Have a community do not resuscitate order.
- Have a terminal illness, end-of-life care, or illness likely to result in death within the study period.
- Have no mode of contact or follow-up.
- Plan to move away from Toronto during the study period.
- Have insufficient English language skills to participate in the study.
- Are an active or previously practicing healthcare professional or professional first responder (e.g.: firefighter, police officer, lifeguard, industrial first responder).
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description SOONER Training and Naloxone Kit SOONER Training and Naloxone Kit Kit Participants in this arm will be shown the SOONER overdose response training video at the time of recruitment and given the SOONER Naloxone kit to take home. Community or Hospital-Based Training Community or Hospital-Based Training Control arm - participants in this arm will be referred to the standard of care for Naloxone training. This standard of care includes community-based OEND programs and/or an existing hospital-based OEND program..
- Primary Outcome Measures
Name Time Method Participant recruitment rate (participants recruited in 4 weeks) 4 weeks Approximately 28 participants are recruited within 4 weeks.
The recruitment and retention strategy will be deemed "feasible" if BOTH of the following conditions are met:
(A) approximately 28 participants are recruited within 4 weeks, AND (B) there is less than 50% attrition at the underlying study's outcome simulation.Participant attrition at the underlying study's outcome simulation 4-6 weeks less than 50% attrition at the underlying study's outcome simulation.
Primary outcome description: The recruitment and retention strategy will be deemed "feasible" if BOTH of the following conditions are met:
(A) approximately 28 participants are recruited within 4 weeks, AND (B) there is less than 50% attrition at the underlying study's outcome simulation.
- Secondary Outcome Measures
Name Time Method Site recruitment rates 28 days Rate of participant recruitment in each of the family practice, emergency department, and addiction medicine sites associated with a single academic health care centre.
Participant retention rates 4-6 weeks Comparison of retention rate between intervention and control arms
Descriptions of study process problems 4-6 weeks Semi-structured interviews with study participants and unstructured verbal and written feedback from study and recruitment site staff concerning challenges and opportunities for improving any study processes (including participant recruitment, randomization, implementation of the intervention and control, retention, follow-up, outcome assessment and data collection).
Trial Locations
- Locations (4)
St Micheal's Hospital Rapid Access Addictions Medicine Clinic
🇨🇦Toronto, Canada
Inner City Family Health Team
🇨🇦Toronto, Ontario, Canada
St Michael's Hospital Emergency Department
🇨🇦Toronto, Ontario, Canada
St Micheal's Health Centre at 410
🇨🇦Toronto, Ontario, Canada