Oregon Health and Science University
The goal of PEER-Heart is to implement and assess feasibility and preliminary effectiveness of a community peer-facilitated screening for methamphetamine-associated heart failure (MAHF) and linkage to evidence-based cardiology care for people who use methamphetamine in rural areas.
Methamphetamine use has increased across the US in the midst of the opioid crisis, with rates of methamphetamine use in rural communities exceeding that in urban areas. Nationwide, methamphetamine-related hospitalizations increased 270% between 2007 and 2015, along with associated costs, lengths of stay and mortality. Methamphetamine-associated heart failure (MAHF) hospitalizations increased 12-fold over this time period; it is associated with worse symptoms (e.g. ejection fraction) and decreased adherence to guideline-directed medical therapy (GDMT) compared to heart failure not associated wi…
Inclusion Criteria: * Patient-defined regular use of methamphetamine in the last year * Any methamphetamine use in the past 30 days * Age 18 years or older * No client-reported diagnosis of heart failure * Able to communicate in English * Screen positive for potential methamphetamine-associated heart failure (MAHF) defined as B type natriuretic peptide (BNP) ≥50 pg/ml, or QRS width ≥120ms, or presence of any clinical heart failure symptoms Exclusion Criteria: * Self-reported engagement in medical care for heart failure in past 6 months. * Actively taking medications for heart failure.
Peer-facilitated referral to a local primary care provider to follow-up their screening results.
Peer-facilitated virtual consultation with cardiovascular specialist, for follow-up of their screening results. Activities may include: referral for a locally performed testing including echocardiogram and additional blood work, and transitional care management facilitated by a remote nurse care manager and the peer Referral for a locally performed testing including echocardiogram Transitional care management facilitated by a remote nurse care manager and the peer
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