Perspectives of United States–Based Infectious Diseases Physicians on Outpatient Parenteral Antimicrobial Therapy Practice. (20th August 2019)

• Record Type: Journal Article
• Authors: Hamad, Yasir; Lane, Michael A; Beekmann, Susan E; Polgreen, Philip M; Keller, Sara C
• Is Part Of: Open forum infectious diseases. Volume 6:Number 10(2019)
• Publication Date: 2019-08-20
• Subjects: antimicrobial use -- care delivery -- OPAT -- practice management -- patient safety; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofz363
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Although outpatient parenteral antimicrobial therapy (OPAT) is generally considered safe, patients are at risk for complications and thus require close monitoring. The purpose of this study is to determine how OPAT programs are structured and how United States–based infectious diseases (ID) physicians perceive barriers to safe OPAT care. Methods: We queried members of the Emerging Infections Network (EIN) between November and December 2018 about practice patterns and barriers to providing OPAT. Results: A total of 672 members of the EIN (50%) responded to the survey. Seventy-five percent of respondents were actively involved in OPAT, although only 37% of respondents reported that ID consultation was mandatory for OPAT. The most common location for OPAT care was at home with home health support, followed by post–acute care facilities. Outpatient and inpatient ID physicians were identified as being responsible for monitoring laboratory results (73% and 54% of respondents, respectively), but only 36% had a formal OPAT program. The majority of respondents reported a lack of support in data analysis (80%), information technology (66%), financial assistance (65%), and administrative assistance (60%). The perceived amount of support did not differ significantly across employment models. Inability to access laboratory results in a timely manner, lack of leadership awareness of OPAT value, and failure to communicate with other providers administering OPAT were reported as the most challenging aspects of OPAT care. Conclusions: ID providers were highly involved in OPAT, but only one-third of respondents had a dedicated OPAT program. Lack of financial and institutional support were perceived as significant barriers to providing safe OPAT care. Abstract : This survey highlights the challenges that face infectious disease physicians as they try to safely care for their patients receiving outpatient parenteral antimicrobial therapy (OPAT). Inability to access lab results in a timely manner and lack of leadership support were identified among the major barriers.