Comparative Usability Study of a Novel Auto-Injector and an Intranasal System for Naloxone Delivery

Area of Science:

• Emergency medicine
• Pharmacology
• Usability studies

Background:

• Injectable naloxone is the standard for reversing opioid-induced respiratory depression.
• Opioid overdose emergencies necessitate rapid and effective naloxone administration.
• Comparing novel delivery systems is crucial for improving emergency response.

Purpose of the Study:

• To compare the usability of a naloxone auto-injector (NAI) and a naloxone intranasal delivery system (NXN).
• To evaluate the success rate of naloxone administration using NAI versus NXN in simulated emergencies.
• To assess the impact of training on the correct use of both devices.

Main Methods:

• 42 healthy participants were randomized to use NAI and NXN sequentially.
• Simulated opioid overdose scenarios were used to test device administration.
• Primary endpoint: successful simulated naloxone dose administration.
• Secondary endpoints: adherence to instructions for use and time to completion.

Main Results:

• NAI showed significantly higher success rates than NXN, both before (90.5% vs. 0.0%) and after (100% vs. 57.1%) training (P < 0.0001).
• Adherence to instructions for use was also significantly greater for NAI (85.7% before, 100% after training).
• Average administration time was substantially shorter with NAI (0.9 min before, 0.5 min after training) compared to NXN (6.0 min before, 2.0 min after training).

Conclusions:

• Laypersons are more successful using NAI compared to NXN for simulated naloxone administration.
• NAI offers a more intuitive and effective delivery method in emergency settings.
• NXN usability was critically low without training, highlighting potential barriers to its effective use.