1 Evaluation of the Take Home Naloxone (THN) Project Trevor Bennett Katy Holloway

2 The THN project started in September 2009 Initially in four areas Swansea Cardiff Newport North Wales Community and prison based T he evaluation started about the same time Data collection finished at the end of 2010 THN Project and Evaluation

3 Community locations Carmarthen Swansea Cardiff Newport Gwent (other than Newport) North Wales Wrexham Anglesey Flintshire Denbighshire Gwynedd Conwy Prison locations HMP Swansea HMP Cardiff HMP Parc HMP Prescoed THN Project and Evaluation

4 The project Training opioid users and their family and friends Use of naloxone Signs of overdose Other life-saving actions Issuing users with a THN kit Providing replacement kits when used THN Project and Evaluation

5 The evaluation design Outcome evaluation Process evaluation THN Project and Evaluation

6 Outcome evaluation aims To determine whether THN training had a positive impact on clients Improved recognition of OD events Improved knowledge of treating OD cases To monitor naloxone use THN Project and Evaluation

7 Outcome evaluation methods Questionnaires Replenishment forms Interviews with project staff THN Project and Evaluation

8 Naloxone training questionnaire THN Project and Evaluation

9 Process evaluation aims To determine implementation effectiveness To determine the number of people trained and issued with THN THN Project and Evaluation

10 Process evaluation methods Monitoring records Observations of training sessions Interviews with project staff Interviews with service users THN Project and Evaluation

11 Process evaluation methods THN Project and Evaluation

12 Outcome evaluation results (A)Changes in knowledge (B)Changes in confidence and willingness to administer naloxone (C)Ability to manage overdose events THN Project and Evaluation

13 (A) Changes in knowledge THN Project and Evaluation

14 (B) Changes in willingness to use naloxone THN Project and Evaluation

15 (B) Changes in confidence to use naloxone THN Project and Evaluation

16 (C) Managing overdose events THN Project and Evaluation The main questions were: Are trainees able to use naloxone in real-life situations? Will they rely solely on naloxone and neglect other life-saving methods? Will OD cases who have received naloxone survive?

17 (C) Managing overdose events THN Project and Evaluation

18 (C) Managing overdose events THN Project and Evaluation

19 Process evaluation Monitoring records Observations of training sessions Interviews with project staff Interviews with service users THN Project and Evaluation

20 Monitoring records Number of clients trained and kits distributed THN Project and Evaluation

21 Observations of training sessions THN Project and Evaluation

22 Observations of training sessions THN Project and Evaluation Delays starting Other observers Injection training

23 Interviews with site leaders THN Project and Evaluation Management issues Recruitment

24 Interviews with clients THN Project and Evaluation The THN scheme as a whole The training sessions

25 Interviews with clients THN Project and Evaluation Recruitment

26 In many ways, the demonstration project was successful Knowledge about OD events improved Willingness to take action improved Naloxone was effectively used in real-life situations The evaluation report recommended rolling out the programme nationwide Conclusions

27 There were some problems that should be addressed R2 Stronger guidance needed on implementation R3 Sustainability independent of key individuals R7 Recruitment methods to be reviewed R9 Limit or eliminate observers from training sessions R10 Shorten training sessions Conclusions