Full Citation
Title: Propensity score-weighted analysis of the impact of outpatient parenteral antimicrobial therapy (OPAT) plan reconciliation on unscheduled care
Citation Type: Journal Article
Publication Year: 2025
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ISSN: 2328-8957
DOI: 10.1093/OFID/OFAF343
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Abstract: Background: Outpatient parenteral antimicrobial therapy (OPAT) is a mechanism for delivery of antimicrobial therapy outside of inpatient care; however, risks associated with OPAT combined with transition-of-care vulnerabilities may result in unscheduled healthcare use. On 6/15/2020, our institution launched a program entailing OPAT plan review and reconciliation by infectious diseases (ID) pharmacists prior to hospital discharge. We analyzed the frequency of all-cause 90-day emergency department (ED) visits, readmissions, and mortality of patients pre-and post-implementation of OPAT plan reconciliation. Methods: Unique, adult OPAT recipients discharged to home or a post-acute care facility from an academic hospital before (6/1/2017-6/14/2020) and after (6/15/2020-6/30/2022) implementation of ID pharmacist review and reconciliation of OPAT plans were included. We performed a ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ # 2 propensity score-weighted analysis to compare 90-day outcomes pre-and post-intervention while adjusting for relevant clinical characteristics. We accounted for missing data by using multiple imputation. Results: A total of 2408 OPAT patients met inclusion criteria: 1650 pre-implementation and 758 post-implementation. Patients in the post-implementation group had statistically fewer ED visits (pre: 22.2%; post: 17.8%; p = 0.02) and hospital readmissions (pre: 38.9%; post: 33.4%; p = 0.01) within 90 days after discharge from index admission when compared to the pre-implementation cohort. There was no significant difference in the 90-day all-cause mortality between cohorts. Conclusions: Following implementation of OPAT plan reconciliation by ID pharmacists prior to discharge to home from acute care, OPAT recipients were significantly less likely to experience 90-day ED visits or 90-day readmissions.
Url: https://dx.doi.org/10.1093/ofid/ofaf343
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Authors: Ross A#, Jennifer K; Sieling, William D; Billmeyer, Kaylyn N; Hirsch, Elizabeth B; Evans, Michael D; Kline, Susan E; Galdys, Alison L; Ross, Jennifer; Fairview, Health
Periodical (Full): Open Forum Infectious Diseases
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