Dedicated paediatric Outpatient Parenteral Antimicrobial Therapy medical support: a pre–post observational study

Mace, Ariel O; McLeod, Charlie; Yeoh, Daniel K; Vine, Julie; Chen, Yu Ping; Martin, Andrew C.; Blyth, Christopher C; Bowen, Asha C

doi:10.1136/archdischild-2017-313071

Cited by 22 publications

(15 citation statements)

References 20 publications

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“…Whilst there is a developing body of evidence addressing the clinical outcomes of children requiring OPAT [4,10], it is also clear that there is a real deficit of evidence about the experiences of children and their parents [15] and almost no literature considering the perspectives of clinicians. This study addresses this deficit by exploring these perspectives.…”

Section: Discussionmentioning

confidence: 99%

“…It also a reflects other policies such as reducing the length and number of inpatient stays, a belief that OPAT is a more cost-effective option when compared to continued inpatient care [7][8][9] and it may reduce healthcare-associated infections [1]. However, OPAT is not without risk [10] and a systematic review concludes further improvements in paediatric OPAT are needed for safe and effective implementation [4]. Additionally, few studies have reported in any detail about the OPAT experiences of children and their parents.…”

Section: Introductionmentioning

confidence: 99%

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Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): An e-survey of the experiences of parents and clinicians

et al. 2021

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Background Little evidence exists about parental satisfaction and their influence on referral to paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT). Aim This study aimed to examine the experiences of parents, children and clinicians of OPAT at a large tertiary children’s hospital. Method A prospective e-survey, using closed and open questions, of parents (n = 33) of 33 children who had received OPAT (3 children completed a survey), and clinicians (n = 31) involved in OPAT at a tertiary hospital. Data were collected September 2016 to July 2018. Results Data were analysed using simple descriptive statistics. The results show that OPAT offered benefits (less stress, re-establishment of family life) compared to hospital-based treatment for parents and children, although some were anxious. Clinicians’ referral judgements were based on child, home, and clinical factors. Some clinicians found the process of referral complex. Conclusion Most parents and children were satisfied with the OPAT service and preferred the option of home-based treatment as it promoted the child’s comfort and recovery and supported family routines.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): An e-survey of the experiences of parents and clinicians

et al. 2021

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“…This crucial involvement can improve clinical outcomes, decrease antimicrobial resistance, and reduce the cost of treatment. Other studies demonstrated that the involvement of an infectious diseases physician in these programs has reduced re-admissions and emergency room visits [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Implementing the First Outpatient Parenteral Antimicrobial Therapy (OPAT) Program to Utilize Disposable Elastomeric Pumps in the Gulf Region: Results From a Tertiary Teaching Hospital in the Kingdom of Saudi Arabia

Zikri¹,

Al-Faraj²,

Kamas³

et al. 2021

Cureus

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To describe the implementation process, safety, and efficacy outcomes, as well as cost-effectiveness, of the first outpatient parenteral antimicrobial therapy (OPAT) program to utilize disposable elastomeric pumps in the Kingdom of Saudi Arabia and the entire Gulf region. MethodsThis OPAT program was initiated in May 2018 and was administered through a multidisciplinary team that included the home medicine department, pharmacy department, nursing department, and the infectious diseases service. The device used was the Intermate® (Baxter, Deerfield, Illinois) elastomeric pump. After consultation with an infectious diseases physician, eligible patients were discharged home to complete the remainder of their antimicrobial treatment, which was self-administered via the elastomeric devices. ResultsFrom May 2018 to December 2019, 47 patients received 55 courses of OPAT via the new program. A total of 2,869 pumps were used during that period to provide 927 days of antimicrobial therapy in the home setting. Most patients completed the program successfully with no reported significant OPAT-related complications such as catheter-related infections. Four patients were re-admitted for relapse of infections and one patient was re-admitted for colistin-induced nephrotoxicity. No mortality was reported for any patient during OPAT treatment and 30 days after program completion. ConclusionsThe implementation of this novel OPAT program was safe, effective, and offered significant cost-savings to our institution. The entire process was very dynamic and was centered around proper patient selection and education as well as excellent communication between patients and the entire multidisciplinary team involved in the program. We hope that these results will encourage other institutions in the region to implement similar OPAT programs to alleviate the existing bed crisis due to the ongoing COVID-19 pandemic.

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“…The growing evidence about the clinical outcomes of OPAT for children2 5 10 has overlooked the perspectives and experiences of children and their parents12 and a mix of methodological issues and the age of the studies limits the utility of this evidence to current practice. The suggested standardised survey for routinely collecting patient/parent satisfaction1 is unlikely to generate the range and depth of experience that will illuminate practice.…”

Section: Discussionmentioning

confidence: 99%

“…Outpatient parenteral antimicrobial therapy (OPAT) for children is the parenteral administration of antimicrobials for at least two consecutive days without an intervening hospitalisation 1. Children with suspected serious bacterial infections2–6 but who are sufficiently stable and where other factors (eg, child’s medical history) are taken into consideration may be appropriate for OPAT. Children are most commonly referred to OPAT after a period of hospitalisation, but in some cases directly from the emergency department.…”

Section: Introductionmentioning

confidence: 99%

Being ‘at-home’ on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents’ experiences of paediatric OPAT

et al. 2019

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ObjectiveTo better understand the factors that facilitate and hinder a positive experience of paediatric outpatient parenteral antimicrobial therapy (OPAT).DesignQualitative study using semistructured interviews.SettingA dedicated paediatric consultant-led hospital-based, outreach OPAT service in England.ParticipantsParticipants were primarily parents of children who had received OPAT; one child participated.MethodsChildren and parents of children who received OPAT and who had participated in the survey phase of the larger study were invited to be interviewed.Results12 parents (10 mothers and 2 fathers) of 10 children participated; one child (aged 15 years). Data analysis resulted in one meta-theme, ‘At-homeness’ with OPAT, this reflected the overall sense of home being a place in which the children and their parents could be where they wanted to be. Four key themes were identified that reflect the ways in which parents and children experienced being at-home on OPAT: ‘Comfort, security, freedom, and control’; ‘Faith, trust and confidence’; ‘Explanations and communication’ and ‘Concerns, restrictions and inconveniences’.ConclusionsDespite feeling anxious at times, parents reported that they and their children generally had a positive experience of OPAT; being at-home brought many benefits compared with in-patient care. Recommendations arising from the study include a ‘whole-system’ approach to discharge home that includes support related to return to school/nursery, reduction in disruptions to home-based routines, more clarity on choice and preparation for managing potential anxiety, better consideration of dose timing and enhanced preparation and information.

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Dedicated paediatric Outpatient Parenteral Antimicrobial Therapy medical support: a pre–post observational study

Abstract: The introduction of a formal medical team to HiTH demonstrated a positive clinical impact on OPAT patients' outcomes. These findings support the ongoing utility of medical governance in a nurse-led HiTH service.

Cited by 22 publications

References 20 publications

Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): An e-survey of the experiences of parents and clinicians

Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): An e-survey of the experiences of parents and clinicians

Implementing the First Outpatient Parenteral Antimicrobial Therapy (OPAT) Program to Utilize Disposable Elastomeric Pumps in the Gulf Region: Results From a Tertiary Teaching Hospital in the Kingdom of Saudi Arabia

Being ‘at-home’ on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents’ experiences of paediatric OPAT

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