Early Infectious Disease Outpatient Follow-up of Outpatient Parenteral Antimicrobial Therapy Patients Reduces 30-Day Readmission

Saini, Ena; Ali, Mohammad; Du, Ping; Crook, Tonya; Zurlo, John

doi:10.1093/cid/ciz073

Cited by 29 publications

(22 citation statements)

References 9 publications

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“…A total of 471 (471/818, 57.6%) reported that they were exposed to a patient with COVID-19 within the past 14 days of the interview. A total of 701 (701/814, 86.2%) patients visited a hospital due to suspicious signs and symptoms, and 59 (59/814, 7.2%) patients sought medical attention due to being exposed to people with probable COVID- 19 During the initial data collection phase, more than 5000 phone calls were made. Overall, 577 reports were recorded in the daily critical case report sheets.…”

Section: Resultsmentioning

confidence: 99%

“…Given the burden of COVID-19 on health care systems in resource-limited settings such as Iran, telephone-based follow-up studies that involve medical students may not only enhance patient care, but also enhance medical education for medical students, who are often left out of the COVID-19 response due to concerns about limited personal protective equipment resources and students' safety [15]. Early, postdischarge telephone follow-up calls have previously been shown to improve patients' health outcomes and reduce their chances of readmission or critical condition development in the first month after discharge [16][17][18][19].…”

Section: Xsl • Fomentioning

confidence: 99%

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Clinical and Epidemiological Characteristics of Postdischarge Patients With COVID-19 in Tehran, Iran: Protocol for a Prospective Cohort Study (Tele-COVID-19 Study)

Khave¹,

Vahidi²,

Shirini³

et al. 2021

JMIR Res Protoc

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Background COVID-19 was declared a pandemic on March 11, 2020. Given that the severe shortage of hospital beds has led to early discharge and insufficient patient education on home care routines and isolation protocols, the close follow-up of patients and their immediate relatives is an integral part of transitioning from hospital care to home care for patients with COVID-19. Objective We designed the Tele-COVID-19 prospective cohort to follow-up with COVID-19 patients in Tehran, Iran, and improve health care delivery and the recording of postdischarge patients’ clinical profiles. Methods All adult patients who were admitted to the COVID-19 wards of teaching hospitals in Tehran, Iran were eligible to participate in this cohort study. At baseline, patients were recruited from 4 major hospitals from March 9, 2020 to May 20, 2020. Telephone follow-ups, which were led by volunteer medical students, were conducted on postdischarge days 1-3, 5, 7, 10, and 14. We collected data on a range of sociodemographic, epidemiological, and clinical characteristics by using a standard questionnaire. Results Of the 950 patients with confirmed COVID-19 who were approached, 823 (response rate: 86.6%) consented and were enrolled into the cohort. Of the 823 participants, 449 (54.5%) were male. The mean age of participants was 50.1 years (SD 12.6 years). During the initial data collection phase, more than 5000 phone calls were made and over 577 reports of critical patients who were in need of urgent medical attention were recorded. Conclusions The Tele-COVID-19 cohort will provide patients with sufficient education on home care and isolation, and medical advice on care and the proper use of drugs. In addition, by preventing unnecessary hospital returns and providing information on household SARS-CoV-2 transmission as early as possible, this cohort will help with effective disease management in resource-limited settings. International Registered Report Identifier (IRRID) DERR1-10.2196/23316

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Section: Resultsmentioning

confidence: 99%

Section: Xsl • Fomentioning

confidence: 99%

Clinical and Epidemiological Characteristics of Postdischarge Patients With COVID-19 in Tehran, Iran: Protocol for a Prospective Cohort Study (Tele-COVID-19 Study)

Khave¹,

Vahidi²,

Shirini³

et al. 2021

JMIR Res Protoc

View full text Add to dashboard Cite

show abstract

“…Although this is a reasonable complication rate and we cannot infer causation in this retrospective study, it could be improved. Others note that outpatient follow-up within 2 weeks was associated with lower risk of allcause 30-day readmission (adjust odds ratio = 0.33; P = .0001), 19 but short-term follow-up is not always feasible for the both the patient and the physician. The role of telehealth visits to "check in" on OPAT patients on a weekly or biweekly bases needs to be explored further.…”

Section: Discussionmentioning

confidence: 99%

Experiences in outpatient parenteral antimicrobial therapy (OPAT): Barriers and challenges from the front lines

Bailey

Pryor

et al. 2021

ASHE

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Background: Outpatient parenteral antimicrobial therapy (OPAT) is now the standard of care for managing patients who no longer need inpatient care but require prolonged intravenous antimicrobial therapy. OPAT increases patient satisfaction, reduces the lengths of hospital stay, lowers emergency department readmission rates, and decreases total healthcare spending. Objective: To investigate Virginia Commonwealth University Health System’s experience with OPAT and to highlight the obstacles patients and clinicians face when navigating and utilizing this program. Design: We conducted this descriptive study at a large, academic, tertiary-care hospital in Central Virginia. Methods: We performed manual reviews of electronic medical records of 602 patient, and we evaluated the records of those receiving OPAT between 2017 and 2020. Reviews included antimicrobial agents, diagnoses requiring OPAT, adverse effects related to antimicrobials, adverse effects related to peripherally inserted central catheters (PICC), readmission rate, discharge destination, and death. We evaluated our program with descriptive statistics. Results: Among 602 patients who received OPAT, most were diagnosed with bacteremia or musculoskeletal infections. Patients were either discharged home or to another healthcare facility, with the former comprising most of the rehospitalizations. Ertapenem and vancomycin were associated with the most adverse drug events among our cohort. Elevated transaminase levels were noted in 23% of patients. The rate of PICC-line adverse events in this study population was 0.05%. Conclusions: Our findings highlight the barriers and challenges that patients and providers face when receiving OPAT, and they can inform efforts to improve patient clinical outcomes.

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“…Early post-discharge OPAT follow-up is necessary for timely detection and management of these events. Outpatient ID follow-up, including review and assessment of laboratory testing and adverse events within 2 weeks of hospital discharge, has been associated with reduced readmissions in patients receiving OPAT [41].…”

Section: Safety Monitoringmentioning

confidence: 99%

Recent Updates in Antimicrobial Stewardship in Outpatient Parenteral Antimicrobial Therapy

Mahoney

Childs‐Kean

Khan

et al. 2021

Curr Infect Dis Rep

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Early Infectious Disease Outpatient Follow-up of Outpatient Parenteral Antimicrobial Therapy Patients Reduces 30-Day Readmission

Cited by 29 publications

References 9 publications

Clinical and Epidemiological Characteristics of Postdischarge Patients With COVID-19 in Tehran, Iran: Protocol for a Prospective Cohort Study (Tele-COVID-19 Study)

Clinical and Epidemiological Characteristics of Postdischarge Patients With COVID-19 in Tehran, Iran: Protocol for a Prospective Cohort Study (Tele-COVID-19 Study)

Experiences in outpatient parenteral antimicrobial therapy (OPAT): Barriers and challenges from the front lines

Recent Updates in Antimicrobial Stewardship in Outpatient Parenteral Antimicrobial Therapy

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