AI Article Synopsis
- The study aimed to assess whether a structured outpatient parenteral antimicrobial therapy (OPAT) program, supervised by an infectious disease physician and managed by an OPAT nurse, reduced hospital readmission rates and complications.
- A total of 428 patients requiring intravenous antibiotics after hospital discharge were analyzed, comparing outcomes before and after the implementation of this structured program.
- Results showed a significant reduction in hospital readmissions related to OPAT (17.8% to 7%) and an increase in clinical cure rates (from 69.8% to 94.9%) following the program's implementation.
Article Abstract
Objective: To determine whether a structured OPAT program supervised by an infectious disease physician and led by an OPAT nurse decreased hospital readmission rates and OPAT-related complications and whether it affected clinical cure. We also evaluated predictors of readmission while receiving OPAT.
Patients: A convenience sample of 428 patients admitted to a tertiary-care hospital in Chicago, Illinois, with infections requiring intravenous antibiotic therapy after hospital discharge.
Methods: In this retrospective, quasi-experimental study, we compared patients discharged on intravenous antimicrobials from an OPAT program before and after implementation of a structured ID physician and nurse-led OPAT program. The preintervention group consisted of patients discharged on OPAT managed by individual physicians without central program oversight or nurse care coordination. All-cause and OPAT-related readmissions were compared using the χ test. Factors associated with readmission for OPAT-related problems at a significance level of < .10 in univariate analysis were eligible for testing in a forward, stepwise, multinomial, logistic regression to identify independent predictors of readmission.
Results: In total, 428 patients were included in the study. Unplanned OPAT-related hospital readmissions decreased significantly after implementation of the structured OPAT program (17.8% vs 7%; = .003). OPAT-related readmission reasons included infection recurrence or progression (53%), adverse drug reaction (26%), or line-associated issues (21%). Independent predictors of hospital readmission due to OPAT-related events included vancomycin administration and longer length of outpatient therapy. Clinical cure increased from 69.8% before the intervention to 94.9% after the intervention ( < .001).
Conclusion: A structured ID physician and nurse-led OPAT program was associated with a decrease in OPAT-related readmissions and improved clinical cure.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972539 | PMC |
| http://dx.doi.org/10.1017/ash.2022.330 | DOI Listing |
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