Patients with substance use disorders requiring OPAT
Abstract:
Objectives: Injection-related infections (IRI) are common and often require treatment with prolonged intravenous antibiotics via outpatient parenteral antimicrobial therapy (OPAT). However, patients with substance use disorders (SUD) being treated for IRI with OPAT receive suboptimal postdischarge care. We describe a novel program to co-locate OPAT and SUD supports at skilled nursing facilities (SNFs) in a pilot program to improve clinical outcomes.
Methods: We performed a retrospective chart review of patients with a history of SUD discharged from 2 academic medical centers 2021-2023 to SNFs, including those discharged to pilot SNF and SNFs that were not in a pilot program. We use descriptive statistics to report sociodemographic variables, OPAT outcomes, and SUD outcomes.
Results: Twenty-six patients were discharged to a pilot program SNF, and 172 were discharged to an alternative SNF. Patients discharged to pilot program SNFs went to infectious diseases appointments 73% of the time, versus 51% for alternative SNFs. Patients discharged to pilot program SNFs had a 15% 30-day hospital readmission rate and an 8% infection relapse rate, versus 21% and 22% at the alternative SNFs, respectively. Rates of self-directed discharge from SNFs were similar between groups.
Conclusions: We detail successful implementation of an innovative approach to the care of patients with SUD requiring OPAT at SNFs. More work is needed to evaluate outcomes from similar initiatives and determine how to sustainably scale-up interventions for these patients.
Reference:
Keller SC, Abdel Galil R, Brenon JR, Buzzalino LG, Hessel A, de Brito D, Townsend J, Wright WF, Hawes AM, Falade-Nwulia O, Buresh ME. Implementing a Collaborative Approach to Caring for Patients With Substance Use Disorders Requiring Outpatient Parenteral Antimicrobial Therapy After Discharge. J Addict Med. 2025 Jul 29. doi: 10.1097/ADM.0000000000001562. Epub ahead of print. PMID: 40728209.