1931. Health-related Social Vulnerabilities in a Pediatric Outpatient Antimicrobial Therapy (OPAT) Program
Session: Poster Abstract Session: Clinical Practice Issues: OPAT
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • IDWeek 2018 Poster_3 LEV.pdf (1.1 MB)
  • Background:

    Serious pediatric infections are treated safely with outpatient parenteral or prolonged oral antibiotic therapy (OPAT). The OPAT delivery system can be complex with outcomes complicated by social vulnerabilities in the lives of children on OPAT. Our goal was to better understand the psycho-social challenges pediatric families face undergoing OPAT.

    Methods:

    Caregivers of patients discharged on parenteral or prolonged oral antibiotics and referred to Doernbecher Children’s Hospital OPAT program between July 1, 2017 and December 31, 2017 were eligible for enrollment. We assessed health-related social vulnerabilities using a pre-discharge survey of pediatric caregivers. Child-specific medical information was collected by EMR review. Descriptive statistics were used to characterize social challenges.

    Results:

    26 caregivers completed the survey. Mean patient age was 7.7 years. Infections included osteomyelitis (31%), endocarditis or infectious thrombophlebitis (19%), brain abscess or meningitis (15%), complicated pneumonia (12%), device related infections (12%), or other (12%). Combined, patients spent 1150 days on OPAT (390 parenteral; 760 prolonged oral antibiotic days).

    Of the social vulnerabilities endorsed, economic hardship featured prominently with 31% of caregivers having difficulty paying for food, housing or utilities and 12% having problems with appliances working at home. Among the caregivers, 23% reported inadequate social support, 42% reported psychological problems (31% anxiety; 19% depression), 15% reported involvement with child protective services, and 19% reported other legal concerns. 27% had difficulty getting time off work and 31% requested extra help with coordination of health care services. 58% of caregivers had a high school degree or less.

    Conclusion:

    We identified a large number of social vulnerabilities that likely impact pediatric OPAT care after discharge. Identifying social vulnerabilities for pediatric OPAT patients prior to discharge, such as health literacy or barriers to return visits, could better enable treatment customization or prompt care coordination that better supports pediatric OPAT patients.

    Kimberly Felder, PA-C, MCR1, Natalie Koskela, BS2, Raul Vega-Juarez, BS candidate3, Mauricio Gomez, BS candidate3, Jared Austin, MD4, David Wagner, PhD2, Michael Harris, PhD2, Katharine Zuckerman, MD, MPH5 and Louise Vaz, MD, MPH1, (1)Pediatric Infectious Diseases, Oregon Health and Science University, Portland, OR, (2)Division of Pediatric Psychology, Oregon Health & Science University, Portland, OR, (3)Portland State University, Portland, OR, (4)Division of Pediatric Hospital Medicine, Oregon Health & Science University, Portland, OR, (5)Division of General Pediatrics, Oregon Health & Science University, Portland, OR

    Disclosures:

    K. Felder, None

    N. Koskela, None

    R. Vega-Juarez, None

    M. Gomez, None

    J. Austin, None

    D. Wagner, None

    M. Harris, None

    K. Zuckerman, None

    L. Vaz, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.