system challenges, best practices, and ethical & legal considerations. Future research directions and policy recommendations, based on other health system practices, are provided to improve care and outcomes for PWID requiring PICC lines. Methods/Results: A comprehensive literature search was conducted across multiple academic databases and websites, including PubMed, Google Scholar, institutional repositories, and webinars. The search strategy involved identifying key terms related to PICC line use in PWID, including “PICC line,” “intravenous drug use,” “harm reduction,” “infective endocarditis,” and “antimicrobial therapy.” Relevant articles, reviews, and guidelines were reviewed to capture a wide range of perspectives and findings. The selection process included cross-referencing sources and exploring citations within key sources to ensure a thorough examination of the topic. OPAT remains the standard of care for complex infection and has been shown to be successful in select PWID, with low drop out rates, under clear organizational guidelines and policies. Secondary treatments can be used in some circumstances, but further research needs to be done before this becomes the future standard of
care. A program implementing a multidisciplinary team, including addiction medicine, has shown to improve health outcomes in PWID. The main barriers preventing PWID from achieving health equity include limited addiction care, poor harm reduction services, poor continuity of care, poor access to care, and pervasive stigma. These barriers are rooted in structural biases, social inequalities, and racism at organizational, community, and societal levels. Discussion: In select PWID, Outpatient Antimicrobial Therapy (OPAT) is the gold standard treatment. Basing medical decisions on stereotypes of PWID is discriminatory and violates the ADA in some circumstances. Secondary treatments, like oral antimicrobials, can improve outcomes and reduce readmissions through shared decision-making as opposed to no treatment at all. Future efforts should focus on promoting judgement-free care with a multidisciplinary team, integrating harm reduction into medical education, funding medical respite programs for unhoused PWID needing OPAT, expanding addiction medicine
services, and legally advocating for PWID denied standard care due to their SUD.
SUSTAINABILITY IN HEALTHCARE: EXPLORING INTEREST IN FUTURE IMPROVEMENTS Margaret Conrad, Marla Cannatella, MD; Department of Medicine, LSUHSC, New Orleans, LA.
Introduction: Cardiovascular disease (CVD) remains a leading cause of death and disability globally, with increasing interest in its impact on cognitive function. Prior research suggests strong associations between cardiovascular risk factors and cognitive decline, including dementia. However, there has been limited systematic examination of the neuropsychological tools used to assess cognitive function in long-term observational studies focused on CVDs. This review aims to identify and categorize the specific neuropsychological instruments utilized in such studies, offering insights for future research on the intersection of cardiovascular health and cognitive decline. Methods/Results: A systematic search was conducted using the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and
Data Repository Information Coordinating Center (BioLINCC) database, focusing on publicly available studies related to CVD. Studies were included if they reported neuropsychological testing and excluded if the primary focus was stroke or cerebrovascular accidents. The search process followed PRISMA guidelines. In addition to the BioLINCC search, studies from other sources, such as published protocols and investigator correspondence, were included. Neuropsychological tests were categorized into cognitive domains, such as memory, attention, and processing speed. Modes of test administration (in- person vs. computerized) were also recorded. Of the 22 studies reviewed, nine reported administering neuropsychological instruments. Verbal learning and memory were the most frequently assessed cognitive domains, appearing in six studies. Processing speed and attention/concentration were each measured
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