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Opioid OverdoseNalPORSNCT05072249

European Cohort Study of the Effectiveness of Take Home Naloxone

An observational study of Opioid Overdose, run by King's College London at 6 sites in 3 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study aims to assess the effectiveness of take-home naloxone (THN) to reverse opioid overdose when administered by lay persons in a real world setting. This multicentre, prospective, observational cohort study will be conducted across Europe using a mixed method approach. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Opioid Overdose
What is being tested?
Naloxone
How many people
6,000 participants
Where
6 sitesin 3 countries
Study dates
8 Jun 2021to 30 Dec 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Any of below: 1. Patients in treatment for opioid use disorder (OUD) 2. Out-of-treatment individuals with OUD 3. Family members, friends and other close carers of individuals with OUD 4. Staff working with individuals with OUD

Who may be able to join

  • Member of at least one of the groups above (a-d)
  • Aged ≥18 years
  • Provided with THN supply at time of enrolment (or can demonstrate that they have a supply of THN (in-date) and have received training at time of enrolment).
  • Have access to reliable mobile telephone and can present it.
  • Willing to participate in follow-up
  • Who have provided written informed consent.

Who cannot join

  • The following persons will be excluded:
  • Needs an interpreter
  • Already entered the study
  • Not willing or able to partake in follow-up telephone survey

Trial locations and contacts

6 sites in 3 countries.

6 sites in 3 countries

United Kingdom4 sites, 4 recruiting
  • Birmingham and Solihull Mental Health Foundation Trust

    Birmingham

    Dr Day, e.j.day@bham.ac.uk

    Dr Day

    Recruiting
  • Public Health Wales

    Cardiff

    Ms Smith, Josie.Smith@wales.nhs.uk

    Ms Smith

    Recruiting
  • Scottish Drugs Forum

    Glasgow

    Ms Horsburgh, kirsten@sdf.org.uk

    Ms Horsburgh

    Recruiting
  • South London and the Maudsley

    London

    Dr Kelleher, Mike.Kelleher@slam.nhs.uk

    Dr Kelleher

    Recruiting

Other trials in United Kingdom

Denmark1 site, 1 recruiting
  • SundhedsTeam, Socialforvaltningen, Københavns Kommune

    Copenhagen

    Dr Thiesen, GG63@kk.dk

    Dr Thiesen

    Not yet recruiting

Other trials in Denmark

Sweden1 site, 1 recruiting
  • Stockholm Centre for Dependency Disorders

    Stockholm

    Dr Martin Kåberg, martin.kaberg@sll.se

    Dr Joar Guterstam, joar.guterstam@sll.se

    Recruiting

Other trials in Sweden

About this study

Official title: A Multi-national, Prospective Mixed Methods Study of the Effectiveness of Naloxone (Including Intranasal Nyxoid) Administration by Lay People in Reversing Opioid Overdose

This study aims to assess the effectiveness of take-home naloxone (THN) to reverse opioid overdose when administered by lay persons in a real world setting. This multicentre, prospective, observational cohort study will be conducted across Europe using a mixed method approach. Recruiting 6000 individuals to whom a supply of THN has been provided, for n=600 to witness an opioid overdose. The co-primary outcomes are to determine the rate of administration of naloxone and frequency of deaths in the 24 hours subsequent to the administration of naloxone. This will be captured through structured interviews with those who report witnessing an opioid overdose in the 6 month study period, approximately n=600, to elicit further information on the overdose and any naloxone administered. Naloxone training materials and education provided will be examined through questions in the structured interview. In-depth qualitative interviews will also be conducted with 60 participants who have witnessed an overdose, in order to better understand the use, safety and effectiveness of different naloxone products (particularly Nyxoid). As part of the qualitative analysis, interview transcripts will be assessed by an expert clinician panel for accuracy of diagnosis, actions taken and aftercare. Routine data from national health registers will be used to gather mortality data. This study will report on the use of different formulations of naloxone. In addition, this study serves as a Post Authorisation Efficacy Study (PAES) for the intranasal (IN) naloxone, Nyxoid developed by MundiPharma and focuses on drug safety and training.

Read the detailed description

Accidental opioid overdose is a global crisis. Naloxone is an accessible, safe and effective antidote for this preventable cause of mortality. While it has been used to treat opioid overdose in hospital and pre-hospital settings since the 1970s, take home naloxone programmes have been introduced more recently after opioid users were recognised as potential first responders. This study aims to assess the effectiveness of take-home naloxone (THN) to reverse opioid overdose when administered by lay persons in a real world setting. This multicentre, prospective, observational cohort study will be conducted across Europe using a mixed method approach, recruiting 6000 individuals to whom a supply of THN has been provided (comprising four groups:1. patients in treatment for opioid use disorder (OUD), 2. Individuals using opioids but out-of-treatment, 3. family members, friends and other close carers, and 4. staff working with individuals with OUD) for n=600 to witness an opioid overdose. The co-primary outcomes are to determine the rate of administration of naloxone and frequency of deaths in the 24 hours subsequent to the administration of naloxone.

This will be captured through two stages and two sub-studies. Main study stage 1: All consenting participants (n=6,000) will be asked to complete an enrolment questionnaire with the member of staff recruiting them into the study. In addition, the staff member will be asked to complete a brief record of the naloxone and training provided to the participant. Participants will be texted monthly to prompt them to contact research staff if they have witnessed an opioid overdose. Staff who have frequent or regular contact with participants (including instances when a replenishment of naloxone is given) will also prompt participants to make contact with research staff to notify them of a witnessed opioid overdose. All participants will be contacted at six months and asked to take part in a structured interview. In addition, national/regional death registers will be probed to confirm mortality data for study participants who are at risk of experiencing an opioid overdose themselves.

Main study, Stage 2: Participants who report that they have witnessed an opioid overdose during the six-month follow-up period will be asked to take part in a structured interview with a researcher about this witnessed overdose to capture our primary outcomes (approximately n=600).

Sub-study A: comprises two structured surveys incorporated into a) the Enrolment training information form (to examine naloxone training and materials provided) and b) the Stage 2 Interview completed by participants who have witnessed an overdose (to ask about the extent they followed the nasal naloxone Nyxoid Quick Start Guide (QSG) (or equivalent instructions). The questions are designed to better understand the effectiveness of the Nyxoid nasal naloxone educational and training materials delivered to participants who were provided with Nyxoid nasal naloxone and who were subsequently present at an overdose.

Sub-study B: comprises qualitative interviews with 60 UK participants who witness a diverse range of overdose events of the approx. n=600 (Main Study Stage 2). The aim of sub-study B is to better understand the use, safety, and effectiveness of different naloxone products. Qualitative interviews will be guided by a topic guide and conducted by telephone. The topic guide will capture details of any overdoses experienced or witnessed since the study started before focusing in more depth on the most recent overdose witnessed. Participants will also be asked about any training they have had, or need, in naloxone administration. In addition, a clinical expert assessment of the accurate identification of an opioid overdose and the participant's response to the opioid overdose (as detailed in the transcribed interviews) will be performed and documented. Answers will be assessed by an expert clinician panel for accuracy of diagnosis, actions taken and aftercare.

This study will report on the use of different formulations of naloxone, and different national systems of training and provision. In addition, this study serves as a Post Authorisation Efficacy Study (PAES) for the intranasal (IN) naloxone, Nyxoid developed by Mundipharma and focuses on drug safety and training.

Conditions
Opioid Overdose
Being tested
Naloxone
Keywords
overdose, take home naloxone, opioids, effectiveness, prevention, fatalities, mixed methods
Medical subject headings
Opiate Overdose, Drug Overdose, Death

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NaloxoneDrug

    Also called Prenoxad, Nyxoid, Ventizolve

    Take Home Naloxone for reversing opioid overdose

Study groups in NCT05072249
Study groupRoleWhat they receive
lay person provided with take home naloxoneNaloxone all forms
Receives: Drug: Naloxone

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Frequency of deaths in the 24 hours or later if information is available subsequent to administration of naloxone by lay-persons to reverse an opioid overdose in the real world.

    frequency of deaths among those witnessing opioid overdose (n=600)

    Measured: Ongoing - over six months period post enrolment (at most recent overdose witnessed)

  2. Administration rate of THN with the intention of reversing an opioid overdose by lay persons provided with THN who witness an opioid overdose.

    Rate of THN administration among those witnessing opioid overdose (n=600)

    Measured: Ongoing -over six months period post enrolment (at most recent overdose witnessed)

Secondary outcomes (14)
  1. Percentage of participants who indicate carrying THN (on day of interview)

    Percentage (n=6000)

    Measured: Ongoing over 6-month period post enrolment

  2. Percentage of participants who witness an opioid overdose over 6-month period.

    Percentage (n=6000)

    Measured: Ongoing over 6-month period post enrolment

  3. Confirm death or survival of participants

    percentage (n=600)

    Measured: On-going over 6 month period post enrolment

  4. Percentage of participants who witness an opioid overdose who report there was THN present

    Percentage (n=600)

    Measured: Ongoing over 6-month period post enrolment (at most recent overdose witnessed)

  5. Percentage of participants who are carrying THN when witness an opioid overdose

    Percentage (n=600)

    Measured: Ongoing over 6-month period post enrolment (at most recent overdose witnessed)

  6. Percentage of participants who witness an opioid overdose, where there was THN present, and administer THN

    Percentage (n=600)

    Measured: Ongoing over 6-month period post enrolment (at most recent overdose witnessed)

  7. Percentage of participants who witness an overdose and administer THN who report respiratory depression occurred in person they resuscitated within one hour of administering THN

    Percentage (n=600)

    Measured: On-going within 6-month period post enrolment (at most recent overdose witnessed)

  8. Percentage of participants who witness an overdose, who report a second dose of naloxone administered to a person experiencing an opioid overdose within 1-hour post administration of first dose of THN

    Percentage (n=600)

    Measured: 6-month follow-up (at most recent overdose witnessed)

  9. Percentage of participants who report withdrawal symptoms (including anger, rage and violence) occurred in person they resuscitated with THN

    Frequency of each symptom witnessed (n=600) (at most recent overdose witnessed)

    Measured: On-going over 6-month period post enrolment (at most recent overdose witnessed)

  10. Percentage of participants witnessing an overdose where the person receiving naloxone has survived at 2 hours post administration of naloxone OR at arrival of ambulance/medical assistance if this occurs before 2 hours have passed since opioid overdose

    Percentage (n=600)

    Measured: Ongoing over 6-month period post enrolment

  11. Percentage of participants who witness an opioid overdose and report fatal outcomes within 2 hours of identification of opioid overdose or at arrival of ambulance/medical assistance a) of witnessed opioid overdoses b) Of witnessed opioid overdoses

    Percentage (n=600)

    Measured: Ongoing over 6-month period post enrolment

  12. Percentage of participants who witness an overdose who correctly diagnosed opioid overdose crisis-through multiple response questions

    Percentage (n=600)

    Measured: Ongoing interviews 6-month post enrolment follow-up

  13. Percentage of participants who witness an opioid overdose who correctly diagnose opioid overdose crisis-through multiple response questions

    Percentage (n=600)

    Measured: Ongoing interviews 6-month post enrolment follow-up

  14. Percentage of participants who witness an opioid overdose who correctly respond to opioid overdose crisis-through multiple response questions

    Percentage (n=600)

    Measured: Ongoing interviews 6-month post enrolment follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Oct 2021
  2. Study start8 Jun 2021
  3. Primary completion30 Dec 2023 (estimated)
  4. Study completion30 Dec 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
6,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05072249
Sponsor's protocol ID
MR903 9501
Acronym
NalPORS
Status last verified
Mar 2023
First submitted
8 Jun 2021
Last updated
29 Mar 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Metrebian N, Dascal T, Mackie C, Tinch-Taylor R, Carter B, Neale J, Utrilla MG, Day E, Guterstam J, Horsburgh K, Kaberg M, Kelleher M, Mayet S, Smith J, Eide D, Holmen E, McDonald R, Parkin S, Thiesen H, Strang J; NalPORS Research Team. Overdose reversal through peer intervention: Findings from the naloxone prospective outcome research study (NalPORS) on the effectiveness of overdose response by people who use opioids in the United Kingdom and Sweden. Addiction. 2026 Jul 12. doi: 10.1111/add.70526. Online ahead of print.

    PubMed 42438068
  • Metrebian N, Carter B, Eide D, McDonald R, Neale J, Parkin S, Dascal T, Mackie C, Day E, Guterstam J, Horsburgh K, Kaberg M, Kelleher M, Smith J, Thiesen H, Strang J. A study protocol for a European, mixed methods, prospective, cohort study of the effectiveness of naloxone administration by community members, in reversing opioid overdose: NalPORS. BMC Public Health. 2023 Aug 24;23(1):1608. doi: 10.1186/s12889-023-16445-6.

    PubMed 37612698

Questions about this trial

What is this clinical trial studying?

An observational study of Opioid Overdose, run by King's College London at 6 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 29 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United Kingdom, Denmark, Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Dr Metrebian (07957757235, nicola.metrebian@kcl.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Frequency of deaths in the 24 hours or later if information is available subsequent to administration of naloxone by lay-persons to reverse an opioid overdose in the real world. (time frame: Ongoing - over six months period post enrolment (at most recent overdose witnessed)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05072249, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Mar 2023.

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