Theme: Clinical Research Year: 2024
Background: RESCU is a mixed-methods observational cohort study addressing Scotland’s rise in drug-related deaths (DRD), most caused by opioid-induced respiratory depression. RESCU investigates a chest-worn accelerometer sensor’s ability to accurately capture respiratory patterns of people who use drugs to determine overdose response trigger points. RESCU evaluates device acceptability across participant and stakeholder groups to inform intervention design.
Methods: Participants (n=70) were recruited from an injection equipment provision site in Dundee, during February – December 2022. Participants received a sensor and gateway device to record their breathing for retrospective analysis, recorded their substance use and respiratory data gathered over four weeks, returning for data download weekly.
Semi-structured interviews and focus groups were conducted with RESCU participants (n=21) and stakeholder groups (n=8) about device acceptability, their transcripts were analysed using Reflexive Thematic Analysis. Factors influencing device acceptability and device integration were assessed using the COM-B model and Normalisation Process Theory.
Recorded accelerometer data was analysed using developmental algorithms measuring respiratory rate and frequency and duration of apnoeic episodes.
Results: 8,614 apnoeic episodes of >10s duration were detected at the highest probability level in 6,202.08 hours of respiratory data. 48 participants engaged fully or partially in the study. The mean coverage per participant was 28.06% (SD: 18.67), the average respiratory rate was 11 breaths per minute (SD: 3.36). They used the device for an average of 189.79 hours (SD: 132.70), over an average capture period of 673.38 hours (SD: 184.57).
Data review identified Cheyne-Stokes respiration following opiate and benzodiazepine consumption. No events leading to interventions occurred during monitoring.
Experiences with overdose or DRD were identified as motivating factors for device wear. First responders emphasised patient choice and device accuracy.
Conclusions: Ongoing data analysis suggests successful respiratory anomaly detection. A future aim is trigger point identification. The evaluation highlighted positive therapeutic relationships and patient choice.