ARTEMIS: Advancing Addiction Research and Treatment through Engagement with Rural Marylanders Impacted by PolySubstance Use

ABSTRACT. Despite the significant increase in overdose-related deaths in the past decade, there continues to be a substantial gap in getting services to the individuals who need it most, particularly for individuals with polysubstance use in rural areas. To bridge this gap, clinical research and services must incorporate perspectives of individuals with polysubstance use in rural areas—voices that are often neglected from the research process and care delivery decisions. This proposal builds upon our team’s expertise in developing patient research advisory boards to advance addiction treatment by developing a novel patient engagement resource center (ARTEMIS: Advancing Addiction Research and Treatment through Engagement with Rural Marylanders Impacted by PolySubstance Use). This proposal is directly responsive to patient feedback to create a novel patient engagement resource center focused on improving services for individuals with polysubstance use in rural areas. Our team has conducted preliminary work, including to: (1) establish an urban Research Advisory Committee of individuals with lived experience of substance use to inform and accelerate addiction research; and (2) capture patient-defined barriers to treatment and successful treatment outcomes. Our interdisciplinary team at UMD has a strong history of collaboration with communities and patients, including five rural county health departments, and has established an innovative network of clinical services throughout rural Maryland, including a unique mobile telemedicine unit offering telemedicine buprenorphine prescribing and peer recovery services. We have created a framework for peer-focused clinical research at these sites, led by MPIs Kattakuzhy and Magidson (R01DA057443), offering an opportunity to build upon this infrastructure for ARTEMIS. The overall aim is to establish a sustainable patient engagement resource center to advance patient-centered, integrated care models for polysubstance use in rural areas. Specific aims are to: 1) Form a patient advisory committee and consultation model focused on individuals with polysubstance use in rural areas, guided by the Framework for Continuous Patient and Stakeholder Engagement in Patient Centered Outcomes Research (PCOR); 2) Evaluate patient experiences with polysubstance use care delivery in rural areas to document perceived barriers, preferences and strategies for improving service delivery; 3) Conduct pilot projects designed in partnership with the PAC, with a proposed focus on: a) Understanding patient experiences of polysubstance use, including intentions for and patterns of use; and b) Identifying strategies for addressing social determinants of health and improving functional outcomes. These pilot studies were guided by our team’s preliminary research and patient input, and the study designs will ultimately be based on feedback from Aims 1 and 2. ARTEMIS will leverage the team’s unique strengths to engage in meaningful dialogue with patients with polysubstance use to create a national model for urban-rural academic-community partnerships, and re-center the patient experience of polysubstance use in clinical research and treatment.