Supplementary Material for: Take-Home Naloxone Kits: Attitudes and Likelihood-Of-Use Outcomes from a European Survey of Potential Overdose Witnesses

Background: Injectable naloxone is already provided as take-home naloxone (THN), and new concentrated intranasal naloxone is now being introduced in Europe. Despite evidence of the effectiveness and cost-effectiveness of THN, little is known about the attitudes of key target populations: people who use opioids (PWUO), family/friends, and staff. We examined the acceptability of different naloxone devices (ampoule, prefilled syringe, and concentrated nasal spray) across 5 European countries. Objectives: The aim of this study was to compare THN target groups (PWUO vs. family/friends vs. staff) in their past rates of witnessed overdose and THN administration (as indicators of future use), current THN device preference, and THN carriage on the day of survey. Method: Cross-sectional survey of respondents (age ≥18) in addiction treatment, harm reduction, and recovery services in Denmark, England, Estonia, Norway, and Scotland. A purpose-developed questionnaire (59 items) was administered in the local language electronically or in a pen-and-paper format. Results: Among n = 725 participants, 458 were PWUO (63.2%), 214 staff (29.5%), and 53 (7.3%) family members. The groups differed significantly in their likelihood-of-future THN use (p < 0.001): PWUO had the highest rate of previously witnessing overdoses (352; 77.7%), and staff members reported the highest past naloxone use (62; 30.1%). Across all groups, most respondents (503; 72.4%) perceived the nasal spray device to be the easiest to use. Most reported willingness to use the spray in an overdose emergency (508; 73.5%), followed by the prefilled syringe (457; 66.2%) and ampoules (64; 38.2%). Average THN carriage was 18.6%, ranging from 17.4% (PWUO) to 29.6% (family members). Conclusion: Respondents considered the concentrated naloxone nasal spray the easiest device to use. Still, most expressed willingness to use the nasal spray as well as the prefilled syringe in an overdose emergency. Carriage rates were generally low, with fewer than 1 in 5 respondents carrying their THN kit on the day of the survey.

背景：注射用纳洛酮目前已作为带回家纳洛酮（take-home naloxone, THN）供应，新型浓缩鼻内用纳洛酮现已在欧洲推广应用。尽管已有证据证实THN的有效性与成本效益，但针对三大核心目标人群——阿片类物质使用者（people who use opioids, PWUO）、亲友及工作人员——的态度研究仍较为匮乏。本研究覆盖5个欧洲国家，调研了不同纳洛酮给药装置（安瓿瓶（ampoule）、预充式注射器（prefilled syringe）及浓缩型鼻喷制剂（concentrated nasal spray））的可接受性。
研究目标：本研究旨在对比THN三大目标人群（PWUO、亲友、工作人员）的既往过量用药目击率、THN施用经历（二者均作为未来使用行为的预测指标）、当前对纳洛酮装置的偏好，以及调查当日携带THN的情况。
研究方法：本研究采用横断面调查设计，纳入丹麦、英格兰、爱沙尼亚、挪威及苏格兰的成瘾治疗、减害服务（harm reduction）与康复服务机构中年龄≥18岁的受访者。研究使用自研的59条目问卷，以当地语言通过电子或纸笔形式开展调查。
结果：本次研究共纳入725名参与者，其中458名为PWUO（63.2%）、214名为工作人员（29.5%）、53名为家属（7.3%）。不同人群的未来THN使用意愿存在显著统计学差异（p < 0.001）：PWUO既往目击过量用药事件的比例最高（352人，77.7%），工作人员既往使用纳洛酮的比例最高（62人，30.1%）。在所有研究人群中，多数受访者（503人，72.4%）认为鼻喷制剂是最易用的给药装置。多数受访者表示愿意在过量用药急救场景中使用鼻喷制剂（508人，73.5%），其次为预充式注射器（457人，66.2%）与安瓿瓶（64人，38.2%）。受访者的THN平均携带率为18.6%，区间为17.4%（PWUO）至29.6%（家属）。
结论：受访者普遍认为浓缩型纳洛酮鼻喷制剂是最易用的给药装置。尽管如此，多数受访者均表示愿意在过量用药急救中使用鼻喷制剂及预充式注射器。THN携带率整体偏低，调查当日仅不足五分之一的受访者携带了THN套装。