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Background
Injection drug use-associated infective endocarditis (IDU-IE) is a serious infection of the heart valves or endocardial tissues. IDU-IE is increasingly common in Canada and treatment outcomes are suboptimal. People with IDU-IE face barriers to care including health care-related stigma and lack of pain/withdrawal management. Most hospitals do not have the expertise or resources to coordinate substance use-related care with medical and surgical management of the infection.
Methods
We are facilitating a modified, online Delphi research priority-setting exercise through our pan-Canadian, multidisciplinary working group focused on improving care for people with IDU-IE. We have prioritized the meaningful engagement of people with lived/living experience of drug use at risk of IDU-IE or who have had IDU-IE. The group involves experts in Cardiac Surgery, Cardiology, Nursing, Infectious Diseases, Addiction Medicine, and General Internal Medicine. Priority-setting comprises 3 rounds. First, we solicited potential research priority topics in working group meetings and via survey. We then compiled these into 89 unanswered research questions. In round 2, the working group will rate the importance of these 89 topics on a 1-10 scale. In round 3, the top 30 items will be ranked.
Results
We have completed round 1 and round 2 is ongoing. The 89 research questions cover descriptive epidemiology, primary prevention, social determinants, harm reduction interventions in hospital (including withdrawal management and hospital-based supervised consumption sites), improved hospital services such as peer support and multidisciplinary endocarditis care teams, surgical risk prediction, and coordinated aftercare.
Conclusion
This is a community-engaged project to determine research priorities to improve care for IDU-IE across Canada. Establishing IDU-IE research priorities that our multidisciplinary working group agrees upon will inform research projects and guidelines, funding applications, implementation of novel frontline services, and policy implications.
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