Perspectives of United States-Based Infectious Diseases Physicians on Outpatient Parenteral Antimicrobial Therapy Practice

Yasir Hamad, Michael A. Lane, Susan E. Beekmann, Philip M. Polgreen, Sara C. Keller

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Although outpatient parenteral antimicrobial therapy (OPAT) is generally considered safe, patients are at risk for complications and thus require close monitoring. The purpose of this study is to determine how OPAT programs are structured and how United States-based infectious diseases (ID) physicians perceive barriers to safe OPAT care. Methods: We queried members of the Emerging Infections Network (EIN) between November and December 2018 about practice patterns and barriers to providing OPAT. Results: A total of 672 members of the EIN (50%) responded to the survey. Seventy-five percent of respondents were actively involved in OPAT, although only 37% of respondents reported that ID consultation was mandatory for OPAT. The most common location for OPAT care was at home with home health support, followed by post-acute care facilities. Outpatient and inpatient ID physicians were identified as being responsible for monitoring laboratory results (73% and 54% of respondents, respectively), but only 36% had a formal OPAT program. The majority of respondents reported a lack of support in data analysis (80%), information technology (66%), financial assistance (65%), and administrative assistance (60%). The perceived amount of support did not differ significantly across employment models. Inability to access laboratory results in a timely manner, lack of leadership awareness of OPAT value, and failure to communicate with other providers administering OPAT were reported as the most challenging aspects of OPAT care. Conclusions: ID providers were highly involved in OPAT, but only one-third of respondents had a dedicated OPAT program. Lack of financial and institutional support were perceived as significant barriers to providing safe OPAT care.

Original languageEnglish (US)
Article numberofz363
JournalOpen Forum Infectious Diseases
Volume6
Issue number10
DOIs
StatePublished - Sep 30 2019

Keywords

  • OPAT
  • antimicrobial use
  • care delivery
  • patient safety
  • practice management

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

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