Impact of a Pharmacist-Managed Outpatient Parenteral Antimicrobial Therapy (OPAT) Service on Cost Savings and Clinical Outcomes at an Academic Medical Center.

Autor:	Epperson TM; Department of Pharmacy, Parkland Health, Dallas, Texas., Bennett KK; Clinical and Administrative Sciences, Department of Pharmacy, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma., Kupiec KK; Department of Pharmacy, University of Oklahoma Medical Center, Oklahoma City, Oklahoma., Speigel K; Department of Nursing, University of Oklahoma Medical Center, Oklahoma City, Oklahoma., Neely SB; Clinical and Administrative Sciences, Department of Pharmacy, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma., Resman-Targoff BH; Clinical and Administrative Sciences, Department of Pharmacy, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma., Kinney KK; Infectious Diseases Section, Department of Internal Medicine, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma., White BP; Department of Pharmacy, University of Oklahoma Medical Center, Oklahoma City, Oklahoma.; Infectious Diseases Section, Department of Internal Medicine, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
Jazyk:	angličtina
Zdroj:	Antimicrobial stewardship & healthcare epidemiology : ASHE [Antimicrob Steward Healthc Epidemiol] 2023 Jan 17; Vol. 3 (1), pp. e15. Date of Electronic Publication: 2023 Jan 17 (Print Publication: 2023).
DOI:	10.1017/ash.2022.374
Abstrakt:	Background: Outpatient antimicrobial therapy (OPAT) is managed by a variety of teams, but primarily through an infectious disease clinic. At our medical center, OPAT monitoring is performed telephonically by pharmacists through a collaborative practice agreement under the supervision of an infectious disease physician. The effect of telephonic monitoring of OPAT by pharmacists on patient outcomes is unknown. Methods: This retrospective cohort study was conducted between July 2017 and July 2018 at a 350-bed academic medical center and included adult patients discharged home on IV antibiotics or oral linezolid. The experimental group comprised patients discharged with a consultation for the OPAT management program, whereas the control group comprised patients discharged home without a consultation. The primary outcome was 30-day readmission. Results: In total, 399 patients were included: 243 patients in the OPAT management program group and 156 patients in the control group. The 30-day readmission rates were similar in each cohort (20% vs 19%; P = .8193); however, the 30-day readmission rates were lower in the OPAT management program for patients discharged on vancomycin (19.4% vs 39.1%; P = .004). Conclusions: We did not find a difference in 30-day readmissions between patients receiving pharmacy-driven OPAT management services and those who did not. Patients receiving vancomycin via OPAT had lower 30-day readmissions when included in the pharmacist-driven OPAT management program. Institutions with limited resources may consider reserving OPAT management services for patients receiving antimicrobials that require pharmacokinetic dosing and/or close monitoring. (© The Author(s) 2023.)
Databáze:	MEDLINE
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