Patient Perspectives on an Opioid Overdose Education and Naloxone Distribution Program in the US Department of Veterans Affairs
BACKGROUND:
In
an effort to prevent opioid overdose mortality among Veterans, Department of
Veterans Affairs (VA) facilities began implementing Opioid Overdose Education
and Naloxone Distribution (OEND) in 2013 and a national program began in 2014.
VA is the first national health care system to implement OEND. The goal of this
study is to examine patient perceptions of OEND training and naloxone kits.
METHODS:
Four
focus groups were conducted between December 2014 and February 2015 with 21
patients trained in OEND. Participants were recruited from a VA residential
facility in California with a substance use disorder treatment program
(mandatory OEND training) and a homeless program (optional OEND training). Data
were analyzed using matrices and open and closed coding approaches to identify
what participants liked and did not like, group discussion disagreements, and
suggestions for improvement.
RESULTS:
Veterans
thought OEND training was interesting, novel, and empowering, and that naloxone
kits will save lives. Some veterans expressed concern about using syringes in
the kits. A few patients who never used opioids were not interested in
receiving kits. Veterans had differing opinions about legal and liability
issues, whether naloxone kits might contribute to relapse, and whether and how
to involve family in training. Some veterans expressed uncertainty about the
effects of naloxone. Suggested improvements included active learning
approaches, enhanced training materials, and increased advertisement.
CONCLUSIONS:
OEND
training was generally well-received among study participants, including those
with no indication for a naloxone kit. Patients described a need for OEND and
believed it could save lives. Patient feedback on OEND training benefits,
concerns, opinions, and suggestions provides important insights to inform
future OEND training programs both within VA and in other health care settings.
Training is critical to maximizing the potential for OEND to save lives and
this study includes specific suggestions for improving the effectiveness and
acceptability of training.
By: Oliva EM1, Nevedal A1, Lewis ET1,2, McCaa MD1, Cochran MF1,3, Konicki PE4,5, Davis CS6, Wilder C7,8.
- 1 VA Palo Alto Health Care System - Center for Innovation to Implementation , Menlo Park , CA , USA.
- 2 VA Office of Mental Health Operations - Program Evaluation and Resource Center , Menlo Park , CA , USA.
- 3 Stanford University School of Medicine - Department of Psychiatry and Behavioral Sciences , Stanford , CA , USA.
- 4 Louis Stokes Cleveland VA Medical Center , Cleveland , OH , USA.
- 5 Case Western Reserve University School of Medicine - Department of Psychiatry , Cleveland , OH , USA.
- 6National Health Law Program , Los Angeles , CA , USA.
- 7 Cincinnati VA Medical Center , Cincinnati , OH , USA.
- 8 University of Cincinnati College of Medicine - Department of Psychiatry and Behavioral Neuroscience , Cincinnati , OH , USA.
- Subst Abus. 2015 Dec 16:0.
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