1327. Patient-Centered Outcomes from a Self-Administered Outpatient Parenteral Antimicrobial Therapy Clinic in a Safety-Net Hospital
Session: Poster Abstract Session: Clinical Practice Issues
Friday, October 28, 2016
Room: Poster Hall
Background:

Self-administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT) has been proven to be a safe, cost-effective method of treating patients requiring extended-courses of intravenous antimicrobial therapy. Parkland Memorial Hospital is a large safety-net hospital serving Dallas County, Texas. Since 2009, Parkland has operated an innovative S-OPAT program offering uninsured patients the option to be taught at a 4th grade literacy level to self-administer intravenous (IV) antibiotics by gravity at home with weekly in-clinic follow-up. Patients hang an antibiotic bag above their head, counting the specified drip rate as instructed. S-OPAT patients were found to have better clinical outcomes with a 47% lower 30 day readmission rate then patients discharged with traditional OPAT. Our program vastly improved resource utilization with >27,000 hospital bed days saved in the first 4 years at an estimated cost savings of ~ $40 million

There is little data on patient-reported outcomes when patients choose s-OPAT.  It is important to identify these outcomes however, to help other patients and hospital systems decide if S-OPAT would be a feasible approach to delivering care across settings. 


Methods:

Patients who received s-OPAT from 2009 -2013 were contacted by phone and asked questions about their experience and satisfaction with s-OPAT. The responses were graded on a Leikert scale.

Results:

Responses were received from 151 patients. Of these, 127/148 (86%) rated the quality of S-OPAT over in-patient care as “good” or “very good,” and 128/147 (87%) stated that they were likely to request S-OPAT if they needed IV antibiotics in the future. Among the patients who were employed, 61/82 (74%) rated that the amount of time S-OPAT took to return to work as “good” or “very good.” With regards to the clinic training for S-OPAT, 132/148 (89%) of patients rated the explanations and instructions for training as “good” or “very good,” and 130/147 (88%) said that clinic staff were concerned and responsive to their questions.

Conclusion: Satisfaction was very high among patients who used our s-OPAT clinic and most would prefer to self-administer IV antibiotics should they need them in future. Our program engages and empowers patients to safely and effectively complete IV antibiotic therapy at home and may be applicable to other settings. 

Anisha Ganguly, B.S., B.A.1, Kavita Bhavan, MD, MPH2, Deepak Agrawal, MD, MPH3 and Haru Yamamoto, MD1, (1)UT Southwestern Medical Center, Dallas, TX, (2)Infectious Disease, UT Southwestern Medical Center, Dallas, TX, (3)Gastroenterology, UT Southwestern Medical Center, Dallas, TX

Disclosures:

A. Ganguly, None

K. Bhavan, None

D. Agrawal, None

H. Yamamoto, None

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.