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Second Heart Program

Infective endocarditis (IE) is a severe and highly prevalent infection among people who inject drugs (PWID). While short-term outcomes are similar between PWID and non-PWID, the long-term outcomes among PWID after IE are poor, likely due to gaps in care for PWID both in hospital and after discharge. These gaps include: inadequate treatment of underlying substance use disorder, insecure housing, lack of income supports, and limited access to primary care. While the use of multidisciplinary ‘endocarditis teams’ have been demonstrated to improve health outcomes after IE, the concept of an ‘endocarditis team’ has yet to be adapted to meet the unique needs of PWID with IE.

The Second Heart Program connects PWID with a multidisciplinary team designed to address their unique medical, psychosocial, and health system challenges. The Second Heart Team includes a peer support worker with lived experience, a systems navigator, a family physician, and an addiction medicine physician. This study will assess whether this unique endocarditis team is feasible and effective at engaging PWID with IE.

The study has also been expanded to include an additional qualitative arm aimed at understanding the challenges in transitioning from hospital to community for PWID who have experienced IE within the last year.


Project partners:

  • Canadian Mental Health Association – Hamilton
  • St. Joseph’s Healthcare Hamilton