Rural community peer partnerships for improving methamphetamine -associated heart failure screening and engagement in cardiology care (PEER-Heart): Study protocol.
| Title: | Rural community peer partnerships for improving methamphetamine -associated heart failure screening and engagement in cardiology care (PEER-Heart): Study protocol. |
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| Authors: | Alias-Ferri M; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Kersey CB; University of Washington School of Medicine, Seattle, WA, USA.; Shalen EF; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Department of Medicine, Division of Cardiovascular Medicine, Oregon Health & Science University, Portland, OR, USA.; Cook R; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Gregoire D; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Hoffman K; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Beam M; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Levander XA; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Pertl K; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Stensby A; Saint Louis University School of Medicine, Saint Louis, MO 63104, USA.; Gonzales P; Bay Area First Step, USA.; Smith S; Bay Area First Step, USA.; Evernden T; Bay Area First Step, USA.; Longenecker CT; University of Washington School of Medicine, Seattle, WA, USA.; Korthuis PT; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA.; Chan B; Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, USA. |
| Source: | Drug and alcohol dependence reports [Drug Alcohol Depend Rep] 2026 Jan 29; Vol. 18, pp. 100411. Date of Electronic Publication: 2026 Jan 29 (Print Publication: 2026). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 9918350383506676 Publication Model: eCollection Cited Medium: Internet ISSN: 2772-7246 (Electronic) Linking ISSN: 27727246 NLM ISO Abbreviation: Drug Alcohol Depend Rep Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [Amsterdam] : Elsevier B.V., [2021]- |
| Abstract: | Background: Methamphetamine-associated heart failure (MAHF) is increasingly prevalent in rural communities, where limited specialty care and barriers to healthcare engagement hinder early diagnosis and treatment. Peer-led screening with brain natriuretic peptide (BNP) testing, supported by telemedicine, may enhance early detection and linkage to cardiology care.; Aim: PEER-Heart is a hybrid type 1 effectiveness-implementation trial to evaluate the feasibility, acceptability, and effectiveness of a peer-assisted point-of-care screening protocol and telecardiology intervention for MAHF in rural Oregon.; Methods: We will recruit 122 adults reporting methamphetamine use within the past 30 days from two rural Oregon counties. Individuals will be screened for MAHF by peers using a symptom questionnaire, brain natriuretic peptide (BNP) testing, and a mobile electrocardiogram. Individuals who screen positive will be randomized to a peer-facilitated telecardiology intervention or enhanced usual care (EUC). Primary outcome is linkage to heart failure treatment at 2 months. Secondary outcomes include changes in symptom severity, knowledge, and engagement in guideline-directed medical therapy. Implementation barriers and facilitators will be assessed through interviews and focus groups using thematic analysis and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. We hypothesize that peer-assisted telecardiology will result in higher linkage to care. The study will assess the feasibility and acceptability of peer-delivered cardiovascular screening and telecardiology in high-risk populations.; Conclusion: PEER-Heart addresses a critical gap in early detection and management of heart failure for people who use methamphetamine in rural settings. Findings will inform efforts to scale peer-integrated telemedicine programs for underserved populations with complex needs.; (© 2026 The Author(s).) |
| Competing Interests: | The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This study is fully granted by the American Heart Association (10.13039/100000968AHA) Rural PRO-CARE network grant (AHA23HERNPRH1150360) |
| References: | Subst Abuse. 2021 Oct 13;15:11782218211050360. (PMID: 34675524); J Behav Health Serv Res. 2013 Jan;40(1):111-20. (PMID: 23093443); Harm Reduct J. 2024 Mar 26;21(1):69. (PMID: 38532395); Addict Sci Clin Pract. 2022 Jul 28;17(1):41. (PMID: 35902890); Harm Reduct J. 2024 Feb 4;21(1):29. (PMID: 38311717); Res Involv Engagem. 2023 Aug 2;9(1):63. (PMID: 37533127); J Am Heart Assoc. 2021 Aug 17;10(16):e018370. (PMID: 34365802); J Telemed Telecare. 2018 Jan;24(1):4-12. (PMID: 29320966); BMC Cardiovasc Disord. 2019 Nov 29;19(1):274. (PMID: 31783800); JAMA. 2013 Jul 3;310(1):66-74. (PMID: 23821090); Int J Med Inform. 2021 Dec 11;158:104663. (PMID: 34922178); Implement Sci. 2017 Aug 29;12(1):108. (PMID: 28851459); Addict Sci Clin Pract. 2024 Feb 28;19(1):15. (PMID: 38419101); J Am Coll Cardiol. 2005 Dec 20;46(12):2183-92. (PMID: 16360044); Contemp Clin Trials. 2022 Jan;112:106632. (PMID: 34813962); Front Public Health. 2024 Feb 13;12:1279477. (PMID: 38414902); Int J Environ Res Public Health. 2022 Apr 04;19(7):. (PMID: 35410012); Curr Cardiovasc Risk Rep. 2023;17(6):117-122. (PMID: 37305213); Health Expect. 2023 Dec;26(6):2594-2607. (PMID: 37641398); Cureus. 2023 Aug 21;15(8):e43854. (PMID: 37736450); Subst Abus. 2018;39(3):307-314. (PMID: 28991516); Cureus. 2024 Mar 12;16(3):e55996. (PMID: 38618307); Healthc (Amst). 2022 Sep;10(3):100641. (PMID: 35785613); J Am Coll Cardiol. 2022 May 3;79(17):e263-e421. (PMID: 35379503); Med Care. 2012 Mar;50(3):217-26. (PMID: 22310560); Contemp Clin Trials. 2021 Apr;103:106325. (PMID: 33631356); Addict Sci Clin Pract. 2024 Aug 23;19(1):59. (PMID: 39175066); Am J Emerg Med. 2018 Aug;36(8):1423-1428. (PMID: 29307766); Addict Behav. 2024 Sep;156:108073. (PMID: 38821009); AACN Clin Issues. 2003 Nov;14(4):532-42. (PMID: 14595212); Harm Reduct J. 2018 Oct 22;15(1):52. (PMID: 30348170); Healthcare (Basel). 2024 Mar 25;12(7):. (PMID: 38610138); Intern Med J. 2023 Jan;53(1):21-26. (PMID: 36693638); BMJ. 2013 Jan 08;346:e7586. (PMID: 23303884); J Clin Med. 2023 Jun 26;12(13):. (PMID: 37445312); J Subst Use Addict Treat. 2024 Dec;167:209510. (PMID: 39243982); Lancet. 2020 Mar 14;395(10227):859. (PMID: 32171399); J Card Fail. 2024 Jul;30(7):869-876. (PMID: 37984791); Psychiatr Serv. 2024 Nov 1;75(11):1176-1179. (PMID: 39285736); J Subst Abuse Treat. 2019 Jun;101:38-49. (PMID: 31006553); Heart. 2023 Jan 11;109(3):168-177. (PMID: 36456204); JACC Adv. 2024 Mar 13;3(7):100840. (PMID: 39130045); ESC Heart Fail. 2020 Apr;7(2):407-414. (PMID: 31950731); J Rural Health. 2023 Sep;39(4):772-779. (PMID: 36575145); J Intern Med. 2004 Feb;255(2):206-12. (PMID: 14746557); JMIR Res Protoc. 2019 Jan 11;8(1):e12322. (PMID: 30635261) |
| Grant Information: | K12 DA061526 United States DA NIDA NIH HHS |
| Contributed Indexing: | Keywords: Heart failure screening; Methamphetamine use disorder; Methamphetamine-associated heart failure; Peer recovery support specialists; Telemedicine |
| Entry Date(s): | Date Created: 20260212 Date Completed: 20260212 Latest Revision: 20260402 |
| Update Code: | 20260402 |
| PubMed Central ID: | PMC12887167 |
| DOI: | 10.1016/j.dadr.2026.100411 |
| PMID: | 41676388 |
| Database: | MEDLINE |
Journal Article