Patient Selection in Outpatient Parenteral Antimicrobial Therapy

Nolet, Barbara

doi:10.1016/s0891-5520(05)70023-4

Cited by 22 publications

(9 citation statements)

References 42 publications

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“…The health care team must also have knowledge of the patient's home environment prior to initiation of OPAT. This information is ideally obtained by a visit to the home before or at the time of initiation of therapy, but verbal assessment may suffice [29]. Potential problems, such as the funtioning of utilities, safety issues, cleanliness, substance abuse, access to transportation, and social strife need to be assessed.…”

Section: Patient Evaluation and Selectionmentioning

confidence: 99%

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Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy

Tice

Rehm

Dalovisio

et al. 2004

Journal of Infusion Nursing

124

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EXECUTIVE SUMMARYThese guidelines were formulated to assist physicians and other health care professionals with various aspects of the administration of outpatient parenteral antimicrobial therapy (OPAT). Although there are many reassuring retrospective studies on the efficacy and safety of OPAT, few prospective studies have been conducted to compare the risks and outcomes for patients who receive treatment as outpatients rather than as inpatients. Because truly evidence-based studies are lacking, the present guidelines are formulated from the collective experience of the committee members and advisors from related organizations.Important aspects of OPAT are described in the text and tables and include the following:1. The literature supports the effectiveness of OPAT for a wide variety of infections (table 1 and the Appendix).2. A thorough assessment of the patient's general medical condition, the infectious process, and the home situation is necessary before starting therapy (table 2) 3. Prescribing physicians should be aware of a number of aspects of OPAT which distinguish it from

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Section: Patient Evaluation and Selectionmentioning

confidence: 99%

“…The roles of the patient and caregiver in OPAT must not be underestimated; they both should play a part in planning the OPAT program and followup [29,42]. Education about the infection, complications, treatment plans, potential problems, communication, and expected outcome is necessary.…”

Section: Roles Of the Team Members In Opatmentioning

confidence: 99%

Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy

Tice

Rehm

Dalovisio

et al. 2004

Journal of Infusion Nursing

124

View full text Add to dashboard Cite

show abstract

“…Although no inviolate rules govern the selection of patients for OPAT, responsible physicians must choose candidates on the basis of their assessment of each patient's clinical status, including the medical stability of infection, and their relationship with and/or confidence in available OPAT programs [19]. In general, patients should be afebrile with stable vital signs, and the infection should be reasonably stabilized and nonprogressive.…”

Section: Patient Selection For Opatmentioning

confidence: 99%

“…Patients who require other treatments, such as wound care, ventilatory support, physical therapy, or frequent diagnostic studies, can often be treated outside the hospital with careful planning and adequate support systems [19]. Patients, family members, or other caregivers can be trained to change dressings, maintain equipment, and report observations.…”

Section: Patient Selection For Opatmentioning

confidence: 99%

“…Because the opportunity to inspect a patient's home environment before discharge from the hospital and beginning outpatient therapy is rare, the prescribing physician must rely on thorough interviews with patients and their caregivers to determine that a minimum level of safety and support will be available [19]. Any question regarding such issues should be answered by a home visit.…”

Section: Patient Selection For Opatmentioning

confidence: 99%

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Outpatient Parenteral Antimicrobial Therapy Today

Paladino

Poretz²

2010

CLIN INFECT DIS

146

116

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Since its introduction in the 1970s, outpatient parenteral antimicrobial therapy (OPAT) has become a standard modality for patients with many infections requiring long-term intravenous antibiotic therapy. Delivery of OPAT may occur in physicians' offices, hospital clinics, specialized infusion centers, and currently most often, patient's homes, often self-administered. Patients are selected for OPAT by physicians familiar with both the course of their infections, their personal suitability for outpatient care, and the availability of reimbursement. OPAT is reportedly safe, effective, practical, and cost-effective. An OPAT Outcomes Registry contains information from >11,000 antibiotic courses administered from 1997 through 2000. Although a number of studies are purported to analyze the economic impact of OPAT on health care, a comprehensive, clinical outcomes-based pharmacoeconomic analysis, as described here, has, to our knowledge, yet to be done.

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