"OPTIONS-DC", a feasible discharge planning conference to expand infection treatment options for people with substance use disorder.
Harm reduction
OPAT
Patient-centered care
Substance use disorder
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
09 Aug 2021
09 Aug 2021
Historique:
received:
20
03
2021
accepted:
30
07
2021
entrez:
10
8
2021
pubmed:
11
8
2021
medline:
21
9
2021
Statut:
epublish
Résumé
Serious bacterial infections associated with substance use often result in long hospitalizations, premature discharges, and high costs. Out-of-hospital treatment options in people with substance use disorder (SUD) are often limited. We describe a novel multidisciplinary and interprofessional care conference, "OPTIONS-DC," to identify treatment options agreeable to both patients and providers using the frameworks of harm reduction and patient-centered care. We retrospectively reviewed charts of patients who had an OPTIONS-DC between February 2018 and July 2019 and used content analysis to understand the conferences' effects on antibiotic treatment options. Fifty patients had an OPTIONS-DC during the study window. Forty-two (84%) had some intravenous (IV) substance use and 44 (88%) had an active substance use disorder. Participants' primary substances included opioids (65%) or methamphetamines (28%). On average, conferences lasted 28 min. OPTIONS-DC providers recommended out-of-hospital antibiotic treatment options for 34 (68%) of patients. OPTIONS-DC recommended first line therapy of IV antibiotics for 35 (70%) patients, long-acting injectable antibiotics for 14 (28%), and oral therapy for 1 (2%). 35 (70%) patients that had an OPTIONS-DC completed an antibiotic course and 6 (12%) left the hospital prematurely. OPTIONS-DC expanded treatment options by exposing and contextualizing SUD, psychosocial risk and protective factors; incorporating patient preferences; and allowing providers to tailor antibiotic and SUD recommendations. OPTIONS-DC is a feasible intervention that allows providers to integrate principles of harm reduction and offer patient-centered choices among patients needing prolonged antibiotic treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Serious bacterial infections associated with substance use often result in long hospitalizations, premature discharges, and high costs. Out-of-hospital treatment options in people with substance use disorder (SUD) are often limited.
METHODS
METHODS
We describe a novel multidisciplinary and interprofessional care conference, "OPTIONS-DC," to identify treatment options agreeable to both patients and providers using the frameworks of harm reduction and patient-centered care. We retrospectively reviewed charts of patients who had an OPTIONS-DC between February 2018 and July 2019 and used content analysis to understand the conferences' effects on antibiotic treatment options.
RESULTS
RESULTS
Fifty patients had an OPTIONS-DC during the study window. Forty-two (84%) had some intravenous (IV) substance use and 44 (88%) had an active substance use disorder. Participants' primary substances included opioids (65%) or methamphetamines (28%). On average, conferences lasted 28 min. OPTIONS-DC providers recommended out-of-hospital antibiotic treatment options for 34 (68%) of patients. OPTIONS-DC recommended first line therapy of IV antibiotics for 35 (70%) patients, long-acting injectable antibiotics for 14 (28%), and oral therapy for 1 (2%). 35 (70%) patients that had an OPTIONS-DC completed an antibiotic course and 6 (12%) left the hospital prematurely. OPTIONS-DC expanded treatment options by exposing and contextualizing SUD, psychosocial risk and protective factors; incorporating patient preferences; and allowing providers to tailor antibiotic and SUD recommendations.
CONCLUSIONS
CONCLUSIONS
OPTIONS-DC is a feasible intervention that allows providers to integrate principles of harm reduction and offer patient-centered choices among patients needing prolonged antibiotic treatment.
Identifiants
pubmed: 34372776
doi: 10.1186/s12879-021-06514-9
pii: 10.1186/s12879-021-06514-9
pmc: PMC8351414
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
772Informations de copyright
© 2021. The Author(s).
Références
Prev Med. 2019 Nov;128:105760
pubmed: 31251946
J Addict Med. 2020 Sep/Oct;14(5):415-422
pubmed: 31868830
J Addict Med. 2021 Jan-Feb 01;15(1):20-26
pubmed: 32675798
J Infect Dis. 2020 Sep 2;222(Suppl 5):S494-S498
pubmed: 32877541
Am J Public Health. 2015 Dec;105(12):e53-9
pubmed: 26469651
Clin Infect Dis. 2015 Sep 15;61(6):e26-46
pubmed: 26229122
Soc Sci Med. 2014 Mar;105:59-66
pubmed: 24508718
Clin Infect Dis. 2020 Feb 14;70(5):968-972
pubmed: 31420651
Health Aff (Millwood). 2016 May 1;35(5):832-7
pubmed: 27140989
J Hosp Med. 2018 Apr 25;13(11):752-758
pubmed: 29694454
Ann Intern Med. 2019 Jan 1;170(1):31-40
pubmed: 30508432
J Gen Intern Med. 2019 Dec 12;:
pubmed: 31512181
Clin Infect Dis. 2019 Mar 5;68(6):1041-1043
pubmed: 30165395
J Gen Intern Med. 2002 May;17(5):327-33
pubmed: 12047728
Ann Intern Med. 2018 Sep 4;169(5):335-336
pubmed: 30007032
PLoS One. 2020 Nov 9;15(11):e0242165
pubmed: 33166363
Front Psychiatry. 2020 Sep 11;11:549272
pubmed: 33061915
J Gen Intern Med. 2019 Dec;34(12):2796-2803
pubmed: 31410816
N Engl J Med. 2017 Aug 24;377(8):705-707
pubmed: 28834479
Subst Abus. 2018;39(2):225-232
pubmed: 29595367
Open Forum Infect Dis. 2017 May 23;4(3):ofx102
pubmed: 28680904
Subst Abus. 2020;41(4):419-424
pubmed: 31490736
J Infect Dis. 2019 Jul 2;220(3):346-349
pubmed: 30941402
N Engl J Med. 2019 Jan 31;380(5):415-424
pubmed: 30152252
J Subst Abuse Treat. 2020 Nov;118:108121
pubmed: 32972645
N Engl J Med. 2019 Jan 31;380(5):425-436
pubmed: 30699315
J Hosp Med. 2017 May;12(5):339-342
pubmed: 28459904
Circulation. 2015 Oct 13;132(15):1435-86
pubmed: 26373316
J Addict Med. 2019 Mar/Apr;13(2):85-89
pubmed: 30608265