Development of the invasive candidiasis discharge [I Can discharge] model: a mixed methods analysis.

Autor: Jo J; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA., Tran TT; University of Texas Health Science Center, Houston, TX, USA., Beyda ND; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA., Simmons D; School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, USA., Hendrickson JA; University of Texas MD Anderson Cancer Center, Houston, TX, USA., Almutairi MS; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA.; Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia., Alnezary FS; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA.; Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Medinah, Saudi Arabia., Gonzales-Luna AJ; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA., Septimus EJ; Department of Population Medicine Harvard Medical School, Boston, MA, USA.; Texas A&M College of Medicine, Houston, TX, USA., Garey KW; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Health 2, Houston, TX, 77204, USA. kgarey@uh.edu.
Jazyk: angličtina
Zdroj: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2022 Oct; Vol. 41 (10), pp. 1207-1213. Date of Electronic Publication: 2022 Aug 25.
DOI: 10.1007/s10096-022-04473-w
Abstrakt: Patients with invasive candidiasis (IC) have complex medical and infectious disease problems that often require continued care after discharge. This study aimed to assess echinocandin use at hospital discharge and develop a transition of care (TOC) model to facilitate discharge for patients with IC. This was a mixed method study design that used epidemiologic assessment to better understand echinocandin use at hospital discharge TOC. Using grounded theory methodology focused on patients given echinocandins during their last day of hospitalization, a TOC model for patients with IC, the invasive candidiasis [I Can] discharge model was developed to better understand discharge barriers. A total of 33% (1405/4211) echinocandin courses were continued until the last day of hospitalization. Of 536 patients chosen for in-depth review, 220 (41%) were discharged home, 109 (20%) were transferred, and 207 (39%) died prior to discharge. Almost half (46%, 151/329) of patients discharged alive received outpatient echinocandin therapy. Independent predictors for outpatient echinocandin use were osteomyelitis (OR, 4.1; 95% CI, 1.1-15.7; p = 0.04), other deep-seated infection (OR, 4.4; 95% CI, 1.7-12.0; p = 0.003), and non-home discharge location (OR, 3.9, 95% CI, 2.0-7.7; p < 0.001). The I Can discharge model was developed encompassing four distinct themes which was used to identify potential barriers to discharge. Significant echinocadin use occurs at hospital discharge TOC. The I Can discharge model may help clinical, policy, and research decision-making processes to facilitate smoother and earlier hospital discharges.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz: