- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05679284
A Cross-Sectional Observational Study on Retained Drug Needle Fragments in People Who Use Intravenous Drugs
The Prevalence and Predisposing Factors to Retained Drug Needle Fragments in People Who Inject Drugs: a Protocol for a Cross-sectional Observational Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The clinical significance of retained needle fragments remains unknown. Needle retentions can be asymptomatic, cause local symptoms, and can sometimes even lead to dangerous complications such as needle emboli to the heart or lungs. The most common injection sites are likely the peripheral veins of the arms. However, continuous IVD use leads to vein sclerosis, and patients with long-term use may therefore also use peripheral veins of their lower limbs and even the central veins of the groin or neck. Subcutaneously retained needles can pose a risk of needlestick injury to medical staff during clinical examination and treatment procedures. Unrecognized retained needles can also cause hazards during magnetic resonance imaging.
The study protocol received a positive review from the Tampere University Hospital Ethics Committee (study code: R22037). The researchers subsequently received the organizational permissions necessary to conduct the study. PWIDs will be asked to give written informed consent prior to any study procedures. Participants will be asked to fill in a questionnaire about their basic information, drug use history, previous injection sites, and whether they have had any local complications due to injecting drugs. After the completion of the questionnaire, participants will undergo targeted X-ray imaging of the injection sites. As metallic objects, needle fragments can be visualized with standard X-ray imaging. Female participants of childbearing potential (< 50 years) will undergo urine sample pregnancy testing prior to X-ray imaging. A pilot study with 20 participants will be conducted first. Experiences from the pilot will be used to refine the study protocol if needed. If modifications are made, they will be subjected to ethics review and will be provided on ClinicalTrials.gov. After the pilot study, the researchers aim to recruit an additional 80 patients (totaling up to 100 participants).
Our research questions are 1) What is the prevalence of radiologically confirmed needle retention among PWIDs*? The secondary research questions are
- Do patient-reported symptoms and the suspicion of a retained needle fragments correspond to radiologically confirmed needle retention?
- What are the predisposing factors to needle fragmentation?
- Have PWIDs sought medical attention prior to the study for possible symptoms in the injection sites?
- How frequently are verified needle fragments surgically removed within five years after their detection, and are verified needle fragments a proxy or a risk factor for mortality? *As only patients in outpatient care will be recruited, the sample is not entirely representative of all PWIDs in the study area (e.g., people who are hospitalized or imprisoned are not recruited).
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Otso Arponen, Associate Professor, MD
- Phone Number: +358 50 410 6170
- Email: otso.arponen@tuni.fi
Study Locations
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Tampere, Finland
- Recruiting
- Hatanpää Health Center
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Contact:
- Phone Number: 040 8063649
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- History of intravenous drug use
- Current treatment of the drug abuse problem at a local low-threshold drug abuse service unit or primary health care centre.
- Adherence to fill in the questionnaire
- Participation to X-ray imaging of injection sites
Exclusion Criteria:
- No history of intravenous drug use
- Does not adhere to fill in the questionnaire or refuses X-ray imaging
- Pregnancy
- Underage (18 years old)
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Cases: Intravenous drug users with drug needle fragment retentions
All intravenous drug users from the service units will be asked to participate.
X-ray imaging has the goal to identify patients with needle fragment retentions in subcutaneous tissue.
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To identify needle fragment retentions, the radiologic imaging of all volunteers will be performed with X-ray using radiation doses as low as reasonably achievable (ALARA) and one projection per anatomic site.
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Controls: Intravenous drug users without drug needle fragment retentions
All intravenous drug users from the service units will be asked to participate.
Control group consists of those with no radiologically confirmed subcutaneous needle fragment retentions.
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To identify needle fragment retentions, the radiologic imaging of all volunteers will be performed with X-ray using radiation doses as low as reasonably achievable (ALARA) and one projection per anatomic site.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prevalence of needle fragment retentions among intravenous drug users.
Time Frame: An average of 2 years.
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The prevalence of needle fragment retentions among intravenous drug users.
The number of individuals with at least one radiologically confirmed needle fragment in subcutaneous tissue over the total number of participants.
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An average of 2 years.
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Risk factors for needle fragment retentions in a cross-sectional design
Time Frame: An average of 2 years.
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Risk factors for needle fragment retentions in a cross-sectional design.
Patient characteristics as risk factors for having subcutaneous needle fragment retentions.
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An average of 2 years.
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The proportion of patients with surgically removed needle fragment retentions at five years of follow-up.
Time Frame: Up to 5 years.
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The proportion of patients with surgically removed needle fragment retentions after five years of follow-up.
Patients with needle fragment retentions will be referred to the surgical clinic and will be prospectively followed up through healthcare records.
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Up to 5 years.
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Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Otso Arponen, MD-PhD, Pirkanmaa Hospital District (PSHP)
- Study Chair: Olli PO Nevalainen, MD-PhD, City of Tampere; Tampere University; Pirkanmaa Hospital District (PSHP).
- Study Chair: Irina Rinta-Kiikka, MD-PhD, Tampere university Hospital
- Study Chair: Heidi Laukkala, MD, City of Tampere, Tampere University
- Principal Investigator: Markku Sumanen, MD-PhD, Tampere University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Retained drug needles
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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