Outpatient remdesivir treatment program for hospitalized patients with coronavirus disease-2019: Patient perceptions, process and economic impact.

Autor: Chesdachai S; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: chesdachai.supavit@mayo.edu., Rivera CG; Department of Pharmacy, Mayo Clinic, Rochester, MN, USA., Rosedahl JK; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Philpot LM; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; Department of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA., Dholakia R; Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA., Borah BJ; Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA., Draper EW; Department of Pharmacy, Mayo Clinic, Rochester, MN, USA., Arndt R; Department of Pharmacy, Mayo Clinic Health System, Eau Claire, WI, USA., Ganesh R; Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA., Larsen JJ; Department of Nursing, Mayo Clinic, Rochester, MN, USA., Destro Borgen MJ; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA., Razonable RR; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: razonable.raymund@mayo.edu.
Jazyk: angličtina
Zdroj: Healthcare (Amsterdam, Netherlands) [Healthc (Amst)] 2024 Aug 13; Vol. 12 (4), pp. 100750. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1016/j.hjdsi.2024.100750
Abstrakt: Background: Remdesivir is FDA-approved for the treatment of hospitalized patients with severe COVID-19. Many patients improve clinically to allow for hospital dismissal before completing the 5-day course. In a prior work, patients who continued remdesivir in an outpatient setting experienced better 28-day clinical outcomes. Here, we assessed patients' perspectives and the economic impact of this outpatient practice.
Methods: Hospitalized patients who received remdesivir for COVID-19 at Mayo Clinic, Rochester, from 11/6/2020 to 11/5/2021 and were dismissed to continue remdesivir in the outpatient setting were surveyed. The cost of care was compared between those who remained hospitalized versus those who were dismissed.
Results: 93 (19.8 %) among 470 eligible patients responded to the electronic survey. Responders were older than non-responders. The majority (70.5 %) had symptoms resolved by the time of the survey. Ten (11.4 %) patients had persistent symptoms attributed to long COVID-19. The majority were satisfied with the quality of care (82.3 %) and overall experience (76.0 %) in the infusion clinic. After adjusting for gender, comorbidity score, and WHO severity scale, the predicted costs for the groups were $16,544 (inpatient) and $9,097 (outpatient) per patient (difference of $7,447; p < .01). An estimate of 1,077 hospital bed-days were made available to other patients as a result of this transition to outpatient.
Conclusion: An outpatient remdesivir program that allowed for early dismissal was perceived favorably by patients. The program resulted in significant cost and resource savings, the latter in terms of the availability of hospital beds for other patients needing critical services.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Raymund R. Razonable reports financial support was provided by Gilead. RRR received research funds from Regeneron and Roche on projects unrelated to this study, as member of the DSMB for Novartis, and is on the American Society of Transplantation Board of Directors. CGR has served as member of advisory board for Gilead Inc. BJB is a Boehringer Ingelheim and Exact Sciences Corporation consultant on unrelated projects. Others declare no conflict of interest.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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