700. Patient Preferences in the Emergency Department (ED) Before Treatment for Acute Bacterial Skin and Skin Structure Infection (ABSSSI)
Session: Poster Abstract Session: Stewardship: Data and Program Planning
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • Patient survey ABSSSI(DAL17075 5311)_approved poster - 09-26-17.pdf (194.5 kB)
  • Background: Reducing hospital admission and improving transitions of care can lessen the burden of ABSSSIs in EDs and hospitals. Limited research to date has assessed the patient’s preference for ABSSSI treatment. Understanding patient preferences may provide insights that encourage optimal treatment plans and improve satisfaction with their care.

    Methods: A patient survey was conducted across 5 hospital EDs in the US. After providing informed consent, patients with ABSSSI completed a baseline survey assessing their ABSSSI history and preferences for antibiotic (ABX) therapy [intravenous (IV) versus oral] and treatment location. Patient characteristics and ensuing treatment details were collected from the medical record after the ED or hospitalization was completed. Descriptive statistics were used for analyses.

    Results: Seventy one patients were enrolled and completed the baseline survey. The mean ± SD age was 50 ± 17 years, 22 (31%) had diabetes, and 47 (66.2%) had a previous ABSSSI. The median (25th-75th quartile) lesion size was 190 (53-613) cm2; 51 (71.8%) presented with cellulitis, an abscess, or both. Fifty-four (76.1%) were admitted to the hospital with a median (25th-75thquartile) length of stay of 4.5 (2-9) days. In the ED, vancomycin (39.4%) and beta-lactams (36.6%) were the most common ABX; IV was prescribed in 58/63 (92.1%) patients. Once admitted, 37 (68.5%) and 34 (63%) patients received vancomycin and beta-lactams, respectively. When surveyed, 26 (36.6%) patients preferred to receive ABX at home, while 22 (31.0%) chose hospital stay for one or more nights. The most common ABX preference was a single IV dose to complete treatment, selected by 29 (40.8%) patients. The most important ABX factors were efficacy and their doctor’s opinion, then convenience and route of administration; least important were treatment location, adverse events, and cost.

    Conclusion: In these patients presenting to the ED with ABSSSI, the majority were admitted to the hospital and received IV ABX. Patient preferences for treatment location varied, but many valued therapies that could prevent admission. These data suggest opportunities for improving ABSSSI care by engaging the patient and offering treatment alternatives they may not be aware of.

    Safa Almarzoky Abuhussain, PharmD1,2, Michelle Krawczynski, PharmD3, Serina Tart, PharmD4, Gabrielle Jacknin, PharmD5, Kelsey Kohman, PharmD6, Athena L. Hobbs, PharmD7, Michael D. Nailor, PharmD, BCPS (AQ-ID)8, Katelyn R. Keyloun, PharmD, MS9, David P. Nicolau, PharmD, FCCP, FIDSA1 and Joseph L. Kuti, PharmD1, (1)Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, (2)Department of Pharmacy, Um-alQura university, Makkah, Saudi Arabia, (3)Hartford Hospital, Hartford, CT, (4)Department of Pharmacy, Cape Fear Valley Health, Fayetteville, NC, (5)Department of Pharmacy, University of Colorado, Aurora, CO, (6)Deparment of Pharmacy, Baylor University Medical Center, Dallas, TX, (7)Department of Pharmacy, Baptist Memorial Hospital-Memphis, Memphis, TN, (8)University of Connecticut School of Pharmacy, Storrs, CT, (9)Allergan, plc, Irvine, CA

    Disclosures:

    S. Almarzoky Abuhussain, None

    M. Krawczynski, None

    S. Tart, None

    G. Jacknin, None

    K. Kohman, None

    A. L. Hobbs, None

    M. D. Nailor, None

    K. R. Keyloun, Allergan: Employee , Salary

    D. P. Nicolau, Allergan: Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium

    J. L. Kuti, Allergan: Grant Investigator , Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.