TY - JOUR
AU - A. Brown
AU - S. M. Kelly
AU - T. Agee
AU - J. Hsu
AU - N. Schweizer
AU - G. Chander
AU - L. W. Chang
AU - S. Schwartz
AU - O. Falade-Nwulia
A1 - 
AB - BACKGROUND: Integration of substance use disorder (SUD) care into infectious disease care settings has potential to address high rates of SUD among people with infectious diseases. An understanding of patient perspectives is crucial to optimizing care integration models. METHODS: RESTORE is a low-threshold infectious disease/SUD care integration model incorporating clinician training and support for SUD care provision and peer support for patient engagement implemented in an outpatient infectious disease clinic in Baltimore, Maryland. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, in-depth interviews were completed with participants currently engaged (n = 10) and disengaged (n = 10) from RESTORE. Using a grounded theory approach, themes were synthesized to evaluate reach, effectiveness, maintenance, acceptability, and appropriateness of RESTORE from patients' perspectives. RESULTS: RESTORE participants described a range of experiences and barriers to engaging in SUD treatment prior to RESTORE. Participants' perceptions of effectiveness with RESTORE included observed changes in substance use, mental health, and overall quality of life for many, but not all. Sustained impact of RESTORE engagement on participant outcomes also varied. Acceptability and appropriateness of integrated infectious disease and SUD treatment, RESTORE team care coordination, and peer coaching for self-efficacy in SUD recovery were key mechanisms perceived to impact effectiveness. CONCLUSION: A peer-facilitated integrated infectious disease/SUD care model was regarded as acceptable, appropriate, and effective in improving outcomes for patients with SUD accessing infectious disease care. Additional strategies are needed to optimize outcomes across the spectrum of patients with infectious disease and SUD.
AD - Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA. Electronic address: abrow272@jh.edu.; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA.; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, USA.; Department of General Internal Medicine, University of Washington, Washington, USA.; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
AN - 40570718
BT - Int J Drug Policy
C5 - Opioids & Substance Use
DA - Sep
DO - 10.1016/j.drugpo.2025.104883
DP - NLM
ET - 20250625
JF - Int J Drug Policy
LA - eng
N2 - BACKGROUND: Integration of substance use disorder (SUD) care into infectious disease care settings has potential to address high rates of SUD among people with infectious diseases. An understanding of patient perspectives is crucial to optimizing care integration models. METHODS: RESTORE is a low-threshold infectious disease/SUD care integration model incorporating clinician training and support for SUD care provision and peer support for patient engagement implemented in an outpatient infectious disease clinic in Baltimore, Maryland. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, in-depth interviews were completed with participants currently engaged (n = 10) and disengaged (n = 10) from RESTORE. Using a grounded theory approach, themes were synthesized to evaluate reach, effectiveness, maintenance, acceptability, and appropriateness of RESTORE from patients' perspectives. RESULTS: RESTORE participants described a range of experiences and barriers to engaging in SUD treatment prior to RESTORE. Participants' perceptions of effectiveness with RESTORE included observed changes in substance use, mental health, and overall quality of life for many, but not all. Sustained impact of RESTORE engagement on participant outcomes also varied. Acceptability and appropriateness of integrated infectious disease and SUD treatment, RESTORE team care coordination, and peer coaching for self-efficacy in SUD recovery were key mechanisms perceived to impact effectiveness. CONCLUSION: A peer-facilitated integrated infectious disease/SUD care model was regarded as acceptable, appropriate, and effective in improving outcomes for patients with SUD accessing infectious disease care. Additional strategies are needed to optimize outcomes across the spectrum of patients with infectious disease and SUD.
PY - 2025
SN - 0955-3959
SP - 104883
ST - "It makes all the sense in the world": A qualitative evaluation of patient perspectives on implementation outcomes of a peer-facilitated integrated infectious disease and substance use care model
T1 - "It makes all the sense in the world": A qualitative evaluation of patient perspectives on implementation outcomes of a peer-facilitated integrated infectious disease and substance use care model
T2 - Int J Drug Policy
TI - "It makes all the sense in the world": A qualitative evaluation of patient perspectives on implementation outcomes of a peer-facilitated integrated infectious disease and substance use care model
U1 - Opioids & Substance Use
U3 - 10.1016/j.drugpo.2025.104883
VL - 143
VO - 0955-3959
Y1 - 2025
ER -