Close Patient Follow-up Among Patients Receiving Outpatient Parenteral Antimicrobial Therapy.

Abstract

BACKGROUND\nOutpatient parenteral antimicrobial therapy (OPAT) programs allow patients to receive intravenous treatment in the outpatient setting. We developed a predictive model of thirty-day readmission among hospitalized patients discharged on OPAT from two academic medical centers with a dedicated OPAT clinic for management.\n\n\nMETHODS\nA retrospective chart review was performed and logistic regression was used to assess OPAT and other outpatient clinic follow-up in conjunction with age, sex, pathogen, diagnosis, discharge medication, planned length of therapy, and Charlson comorbidity score. We hypothesized that at least one follow-up visit at the Emory OPAT clinic would reduce the risk for hospital readmission within 30 days.\n\n\nRESULTS\nAmong 755 patients, 137 (18%) were readmitted within 30 days. Most patients (73%) received outpatient follow-up care at Emory Healthcare within 30 days of discharge or prior to readmission, including 52% of patients visiting the OPAT clinic. The multivariate logistic regression model indicated that a follow-up OPAT clinic visit was associated with lower readmission compared to those who had no follow-up visit (OR 0.10, 95% CI 0.06-0.17) after adjusting for infection with enterococci, Charlson score, discharge location, and county of residence.\n\n\nCONCLUSION\nThese results can inform potential interventions to prevent readmissions through OPAT clinic follow-up and to further assess factors associated with successful care transitions from the inpatient to outpatient setting.