@article{ref1,
title="Factors associated with participation in an emergency department-based take-home naloxone program for at-risk opioid users",
journal="Annals of emergency medicine",
year="2017",
author="Kestler, Andrew and Buxton, Jane and Meckling, Gray and Giesler, Amanda and Lee, Michelle and Fuller, Kirsten and Quian, Hong and Marks, Dalya and Scheuermeyer, Frank",
volume="69",
number="3",
pages="340-346",
abstract="Study objective Although the World Health Organization recommends take-home naloxone to address the increasing global burden of opioid-related deaths, few emergency departments (EDs) offer a take-home naloxone program. We seek to determine the take-home naloxone acceptance rate among ED patients at high risk of opioid overdose and to examine factors associated with acceptance.  Methods At a single urban ED, consecutive eligible patients at risk of opioid overdose were invited to complete a survey about opioid use, overdose experience, and take-home naloxone awareness, and then offered take-home naloxone. The primary outcome was acceptance of take-home naloxone, including the kit and standardized patient training. Univariate and multivariable logistic analyses were used to evaluate factors associated with acceptance.  Results Of 241 eligible patients approached, 201 (83.4%) completed the questionnaire. Three-quarters of respondents used injection drugs, 37% were women, and 26% identified as &quot;Indigenous.&quot; Of 201 respondents, 137 (68.2%; 95% confidence interval [CI] 61.7% to 74.7%) accepted take-home naloxone. Multivariable analysis revealed that factors associated with take-home naloxone acceptance included witnessing overdose in others (odds ratio [OR] 4.77; 95% CI 2.25 to 10.09), concern about own overdose death (OR 3.71; 95% CI 1.34 to 10.23), female sex (OR 2.50; 95% CI 1.21 to 5.17), and injection drug use (OR 2.22; 95% CI 1.06 to 4.67).  Conclusion A two-thirds ED take-home naloxone acceptance rate in patients using opioids should encourage all EDs to dispense take-home naloxone. ED-based take-home naloxone programs have the potential to improve access to take-home naloxone and awareness in individuals most vulnerable to overdoses.<p /> <p>Language: en</p>",
language="en",
issn="0196-0644",
doi="10.1016/j.annemergmed.2016.07.027",
url="http://dx.doi.org/10.1016/j.annemergmed.2016.07.027"
}