Infection-related hospital readmission is a risk for patients who are receiving outpatient care with intravenous (IV) antibiotic treatment. However, recently, a team of healthcare providers developed a treatment program that succeeded in cutting readmission rates for this population in half.
Outpatient parenteral antibiotic therapy
(OPAT) allows healthcare providers to administer IV antibiotics to patients to treat a wide range of infections in the patient’s home environment, an office, or clinic. With the development of OPAT programs, healthcare providers can continue to safely give their patients infection treatment while reducing healthcare costs and the length of hospital stays. However, patients receiving OPAT care commonly experience complications, antibiotic-related adverse events, and treatment failure resulting in hospital readmission.
In order to address the problem of higher readmission rates, emergency department visits, and mortality in patients receiving outpatient IV treatment, a healthcare team serving patients in the Bronx borough of New York City, developed a new OPAT program.
The new study
, recently published in the journal Open Forum Infectious Diseases
, details the implementation and results of The Transition-of-Care Outpatient Parenteral Antibiotic Therapy (TOC-OPAT) developed by a healthcare team in The Montefiore Health System. The study authors note that their healthcare system serves the poorest borough in New York City and the least healthy county in New York State, where more than 30% of residents live below the poverty level and a high percentage are on Medicaid. Due to crowded living conditions, lack of commercial insurance, and complex chronic infections, OPAT patients in certain populations can experience 30-day hospital readmission rates of up to 50%.
With a team of physicians, homecare agencies, nursing facilities, and a bilingual nurse coordinator, the study group developed the TOC-OPAT program to streamline communication and care. “This was really borne out of our own observations,” said Theresa Madaline, MD, clinical director of Infectious Diseases Services at Montefiore and a lead author of the study, in a recent interview with Contagion®
. Dr. Madaline notes that some of the common infections that her patients receiving OPAT care often get include diabetes-related foot infections, infected joint replacements, obstetrical complications, and skin infections. “We noticed that these patients would go home with the IV antibiotics, and then we’d see them again a couple of weeks later in the hospital with some sort of complication or their infection didn’t get better.”