K H Benjamin Leung, Brian E Grunau, May K Lee, Jane A Buxton, Jennie Helmer, Sean van Diepen, Jim Christenson, Timothy C Y Chan
{"title":"Optimizing placement of public-access naloxone kits using geospatial analytics: a modelling study.","authors":"K H Benjamin Leung, Brian E Grunau, May K Lee, Jane A Buxton, Jennie Helmer, Sean van Diepen, Jim Christenson, Timothy C Y Chan","doi":"10.1503/cmaj.241228","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>More than 85 000 people die annually across North America from opioid poisoning; naloxone in the hands of the public is an effective intervention and saves lives. We compared the accessibility of different placement strategies for public-access naloxone kits.</p><p><strong>Methods: </strong>We evaluated all opioid-poisoning incidents recorded by BC Emergency Health Services between December 2014 and August 2020 in Metro Vancouver, Canada. We determined the number of opioid poisonings \"covered\" (i.e., within a 3-minute walk) by 3 different coverage strategies: (1) existing locations participating in take-home naloxone programs; (2) blanket naloxone kit placement at chain businesses, pharmacies, and registered public-defibrillator locations; and (3) optimization-based strategic kit placement at transit stops based on historical poisonings.</p><p><strong>Results: </strong>We included 14 089 opioid poisonings. Existing locations participating in take-home naloxone programs (647 locations) covered 4988 (35.4%) opioid poisonings. Chain businesses (10-233 locations) covered 6 (0.0%) to 1165 (8.3%) opioid poisonings, and chain business categories (12-810 locations), pharmacies (790 locations), and public-defibrillator locations (980 locations) covered 97 (0.7%) to 3152 (22.4%) opioid poisonings. Optimization-based strategic placement of naloxone kits at transit stops yielded generally higher coverage levels, ranging from 2907 (20.6%) opioid poisonings covered with 10 kit locations, to 7506 (53.3%) with 1000 kit locations.</p><p><strong>Interpretation: </strong>Optimized placement of publicly accessible naloxone kits at transit locations was most effective at improving public accessibility of naloxone, and blanket placement at take-home naloxone program locations covered a substantial proportion of opioid poisonings. Public-access naloxone may improve community access to naloxone in response to opioid poisonings.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E258-E265"},"PeriodicalIF":9.4000,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913478/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Medical Association journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1503/cmaj.241228","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: More than 85 000 people die annually across North America from opioid poisoning; naloxone in the hands of the public is an effective intervention and saves lives. We compared the accessibility of different placement strategies for public-access naloxone kits.
Methods: We evaluated all opioid-poisoning incidents recorded by BC Emergency Health Services between December 2014 and August 2020 in Metro Vancouver, Canada. We determined the number of opioid poisonings "covered" (i.e., within a 3-minute walk) by 3 different coverage strategies: (1) existing locations participating in take-home naloxone programs; (2) blanket naloxone kit placement at chain businesses, pharmacies, and registered public-defibrillator locations; and (3) optimization-based strategic kit placement at transit stops based on historical poisonings.
Results: We included 14 089 opioid poisonings. Existing locations participating in take-home naloxone programs (647 locations) covered 4988 (35.4%) opioid poisonings. Chain businesses (10-233 locations) covered 6 (0.0%) to 1165 (8.3%) opioid poisonings, and chain business categories (12-810 locations), pharmacies (790 locations), and public-defibrillator locations (980 locations) covered 97 (0.7%) to 3152 (22.4%) opioid poisonings. Optimization-based strategic placement of naloxone kits at transit stops yielded generally higher coverage levels, ranging from 2907 (20.6%) opioid poisonings covered with 10 kit locations, to 7506 (53.3%) with 1000 kit locations.
Interpretation: Optimized placement of publicly accessible naloxone kits at transit locations was most effective at improving public accessibility of naloxone, and blanket placement at take-home naloxone program locations covered a substantial proportion of opioid poisonings. Public-access naloxone may improve community access to naloxone in response to opioid poisonings.
期刊介绍：
CMAJ (Canadian Medical Association Journal) is a peer-reviewed general medical journal renowned for publishing original research, commentaries, analyses, reviews, clinical practice updates, and editorials. Led by Editor-in-Chief Dr. Kirsten Patrick, it has a significant impact on healthcare in Canada and globally, with a 2022 impact factor of 17.4.
Its mission is to promote knowledge vital for the health of Canadians and the global community, guided by values of service, evidence, and integrity. The journal's vision emphasizes the importance of the best evidence, practice, and health outcomes.
CMAJ covers a broad range of topics, focusing on contributing to the evidence base, influencing clinical practice, and raising awareness of pressing health issues among policymakers and the public. Since 2020, with the appointment of a Lead of Patient Involvement, CMAJ is committed to integrating patients into its governance and operations, encouraging their content submissions.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
