Initial process evaluation of a pilot intervention development programme utilising the Pneumowave respiratory monitor to prevent drug-related deaths

Author: Kristina Hnízdilová, Brian Stephens, Farsana Ahmad, Christian Sharkey, Jenna Qumsieh, Bruce Henderson, Osian Meredith, Chris Trueman, Madeleine Caven , Lewis Beer, Andrew Radley, John Dillon

Theme: Clinical Research Year: 2023

Scotland experiences a dramatic rise in drug-related deaths, most caused by opioid-induced respiratory depression. RESCU is a mixed-methods observational cohort study, investigating a chest-worn accelerometer sensor’s ability to accurately capture respiratory patterns of people who use drugs (PWUD) to determine overdose response trigger points. It assesses device acceptability to PWUD and third sector and first responder groups to create an intervention pathway.

Participants (n=70) were recruited from an injection equipment provision site in the centre of Dundee. Participants received a sensor and a gateway device to record their breathing for retrospective analysis. Participants recorded their substance use and respiratory data gathered over a four-week period. Participants returned to the site weekly for data download.

Semi-structured interviews and focus groups were conducted with participants who completed the study protocol (n=20) and stakeholder groups (n=8) about device acceptability. Transcripts were analysed using Reflexive Thematic Analysis. Factors influencing device acceptability to participants were mapped onto the COM-B Model of Behaviour. Normalisation Process Theory was used to assess device integration into existing services.
Recorded accelerometer data was analysed using developmental algorithms measuring respiratory rate and frequency and duration of apnoeic episodes.

During February – December 2022, 70 participants had completed or partially completed the study protocol. 8,614 apnoeic episodes of >10s duration were detected at the highest probability level in 6,202.08 hours of respiratory data. No events leading to interventions occurred during monitoring. Experiences with overdose or drug-related death were identified in current qualitative data as motivating factors for device wear. First responder groups stressed the importance of patient choice and device accuracy.

Existing data suggests the device successfully captures respiratory anomalies. The process evaluation revealed the importance of positive therapeutic relationships and participant choice. Data analysis is ongoing, a future study aim being identification of emergency response trigger points.

Download abstract Watch video