The IM-ZBULLE Study : " Z-track " and " Airlock " Techniques During Intramuscular Injection of Haloperidol Decanoate

NCT ID: NCT05995457

Last Updated: 2023-08-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-01

Study Completion Date

2024-11-30

Brief Summary

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Intramuscular injection (IMI) is the process of administering a drug treatment into muscle tissue. The transmission of skills in this care practice is essentially based on the experience of peers. In France, there are no official guidelines for this technical procedure.

Haloperidol decanoate is widely used in psychiatry. This long-acting antipsychotic treatment considerably reduces the risk of relapse and hospitalization. It is administered by IMI. This treatment is invasive, painful and risks complications for the patient. Nurses must ensure that the treatment is as painless as possible, and adapt their practice in line with current recommendations.

Among the various IMI techniques available, the "Z-track" and the "Airlock" limit leakage into subcutaneous tissues when the needle is withdrawn, by locking the active product into the muscular tissues. According to an exploratory study (n=303), 73% of nurses observe active product leakage after injections, and 89% of nurses are not familiar with either the "Z-track" or "Airlock" techniques.

Many foreign studies have been carried out to demonstrate the relevance of these techniques, particularly in terms of pain reduction during treatment, but the results have yet to be confirmed.

The investigators hypothesize that the combined use of the "Z-track" and "Airlock" techniques during intramuscular injection of Haloperidol decanoate is more effective in reducing patient pain than usual practice.

Detailed Description

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This is a multicenter, prospective, randomized, double-blind, controlled, study in 2 parallel groups.

Experimental and control administration protocols will be standardized to harmonize injection practices between the different nurses providing care, and to control some variables. Nurses will have been trained in these protocols and in experimental injection techniques.

The experimental group will be offered an intramuscular injection using the "Z-track" and "Airlock" techniques, while the control group will have an "usual" injection.

An intermediate analysis of futility and efficacy is planned once 50% of the planned sample has completed the study.

The object of the research is the intramuscular injection procedure - Product injected: haloperidol decanoate (Haldol Decanoas®).

Conditions

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Schizophrenia; Psychosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Investigators
Advanced practice nurses (APNs) will carry out clinical examinations before and after the treatment. They will not be present during the treatment, and the patient will not know the technique used, in order to ensure a double-blind evaluation. Only the nurses performing the injection will be aware of the technique used (experimental or control).

Study Groups

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Intramuscular injection of Haloperidol decanoate using the "Z-track" and "Airlock" techniques

Intramuscular injection involves administering the drug treatment Haloperidol decanoate into muscle tissue using the "Z-track" and "Airlock" techniques.

Group Type EXPERIMENTAL

Intramuscular injection of Haloperidol decanoate using the "Z-track" and "Airlock" techniques

Intervention Type OTHER

Intramuscular injection involves administering the drug treatment Haloperidol decanoate into muscle tissue using the "Z-track" and "Airlock" techniques

Control arm, Intramuscular injection as usual

Intramuscular injection involves administering the drug Haloperidol decanoate into muscle tissue using the usual technique

Group Type OTHER

Intramuscular injection of Haloperidol decanoate using standard techniques

Intervention Type OTHER

Intramuscular injection involves administering the drug Haloperidol decanoate into muscle tissue using the usual technique.

Interventions

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Intramuscular injection of Haloperidol decanoate using the "Z-track" and "Airlock" techniques

Intramuscular injection involves administering the drug treatment Haloperidol decanoate into muscle tissue using the "Z-track" and "Airlock" techniques

Intervention Type OTHER

Intramuscular injection of Haloperidol decanoate using standard techniques

Intramuscular injection involves administering the drug Haloperidol decanoate into muscle tissue using the usual technique.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult ;
* having an outpatient treatment in a Mental Health Community Center ("Centre Médico-Psychologique" CMP in french) ;
* with an CIM-10 diagnosis between F20-F29 (Schizophrenia, schizotypal disorder and delusional disorders);
* communicative and able to give free and informed consent to the study;
* prescribed Haloperidol decanoate;
* covered by the french social security

Exclusion Criteria

* Minor ;
* pregnant women ;
* with insufficient understanding of the French language to understand the VAS;
* suffering from any of the following known somatic comorbidity : coagulation disorder, leucopenia, immunosuppression;
* currently prescribed treatment: immunosuppressant, anticoagulant, antibiotic, antiretroviral, other products administered by IMI at dorsogluteal injection sites (antibiotic therapy, hormone therapy, vitamin therapy).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Groupe Hospitalier Paul Guiraud

UNKNOWN

Sponsor Role collaborator

Etablissement Public de Santé Barthélemy Durand

OTHER

Sponsor Role collaborator

Centre Hospitalier St Anne

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rayan BCHINI

Role: PRINCIPAL_INVESTIGATOR

GHU Paris Psychiatry & Neurosciences

Locations

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Rayan BCHINI

Villejuif, , France

Site Status

Countries

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France

Central Contacts

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Rayan BCHINI, IPA

Role: CONTACT

33 1 42 11 75 90

Cécile BERGOT

Role: CONTACT

Facility Contacts

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Rayan BCHINI, Master 2 IPA

Role: primary

+33142117590

References

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Bchini R, Goutte N. [Evidence-based practice and nursing: intramuscular injection in psychiatry]. Soins Psychiatr. 2023 May-Jun;44(346):21-26. doi: 10.1016/j.spsy.2023.04.006. Epub 2023 Jun 7. French.

Reference Type BACKGROUND
PMID: 37328226 (View on PubMed)

Rodger MA, King L. Drawing up and administering intramuscular injections: a review of the literature. J Adv Nurs. 2000 Mar;31(3):574-82. doi: 10.1046/j.1365-2648.2000.01312.x.

Reference Type BACKGROUND
PMID: 10718876 (View on PubMed)

Wynaden D, Landsborough I, Chapman R, McGowan S, Lapsley J, Finn M. Establishing best practice guidelines for administration of intra muscular injections in the adult: a systematic review of the literature. Contemp Nurse. 2005 Dec;20(2):267-77. doi: 10.5172/conu.20.2.267.

Reference Type BACKGROUND
PMID: 16393108 (View on PubMed)

Sanlialp Zeyrek A, Takmak S, Kurban NK, Arslan S. Systematic review and meta-analysis: Physical-procedural interventions used to reduce pain during intramuscular injections in adults. J Adv Nurs. 2019 Dec;75(12):3346-3361. doi: 10.1111/jan.14183. Epub 2019 Sep 13.

Reference Type BACKGROUND
PMID: 31452229 (View on PubMed)

Keen MF. Comparison of intramuscular injection techniques to reduce site discomfort and lesions. Nurs Res. 1986 Jul-Aug;35(4):207-10.

Reference Type BACKGROUND
PMID: 3636818 (View on PubMed)

Kim KS. [Comparison of two intramuscular injection technics on the severity of discomfort and lesions at the injection site]. Kanho Hakhoe Chi. 1988 Dec;18(3):257-68. doi: 10.4040/jnas.1988.18.3.257. Korean.

Reference Type BACKGROUND
PMID: 3230758 (View on PubMed)

Quartermaine S, Taylor R. A comparative study of depot injection techniques. Nurs Times. 1995 Jul 26-Aug 1;91(30):36-9.

Reference Type BACKGROUND
PMID: 7644369 (View on PubMed)

Mac Gabhann L. A comparison of two depot injection techniques. Nurs Stand. 1998 Jun 3-9;12(37):39-41. doi: 10.7748/ns1998.06.12.37.39.c2512.

Reference Type BACKGROUND
PMID: 9732632 (View on PubMed)

Yilmaz DK, Dikmen Y, Kokturk F, Dedeoglu Y. The effect of air-lock technique on pain at the site of intramuscular injection. Saudi Med J. 2016 Mar;37(3):304-8. doi: 10.15537/smj.2016.3.13113.

Reference Type BACKGROUND
PMID: 26905354 (View on PubMed)

Kara D, Yapucu Gunes U. The effect on pain of three different methods of intramuscular injection: A randomized controlled trial. Int J Nurs Pract. 2016 Apr;22(2):152-9. doi: 10.1111/ijn.12358. Epub 2014 Jul 11.

Reference Type BACKGROUND
PMID: 25039702 (View on PubMed)

Ayinde O, Hayward RS, Ross JDC. The effect of intramuscular injection technique on injection associated pain; a systematic review and meta-analysis. PLoS One. 2021 May 3;16(5):e0250883. doi: 10.1371/journal.pone.0250883. eCollection 2021.

Reference Type BACKGROUND
PMID: 33939726 (View on PubMed)

Heshmatifar N, Salari M, Rad M, Afshari Saleh T, Borzoee F, Rastaghi S. A New Approach on the pain management of intramuscular injection: A Triple-Blind Randomized Clinical Trial. Pain Manag Nurs. 2022 Jun;23(3):353-358. doi: 10.1016/j.pmn.2021.01.010. Epub 2021 Mar 11.

Reference Type BACKGROUND
PMID: 33714700 (View on PubMed)

Bloch Y, Mendlovic S, Strupinsky S, Altshuler A, Fennig S, Ratzoni G. Injections of depot antipsychotic medications in patients suffering from schizophrenia: do they hurt? J Clin Psychiatry. 2001 Nov;62(11):855-9. doi: 10.4088/jcp.v62n1104.

Reference Type BACKGROUND
PMID: 11775044 (View on PubMed)

Other Identifiers

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D23-P001

Identifier Type: -

Identifier Source: org_study_id

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