OPTIONS-DC: Treatment Course Outcomes Following Outpatient Parenteral Antimicrobial Therapy RN–Led Multidisciplinary Care Conferences for People Who Use Drugs Hospitalized With Complex Infections - Scorecard - MDSpire
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OPTIONS-DC: Treatment Course Outcomes Following Outpatient Parenteral Antimicrobial Therapy RN–Led Multidisciplinary Care Conferences for People Who Use Drugs Hospitalized With Complex Infections
Clinical Scorecard: OPTIONS-DC: Evaluating Treatment Outcomes After RN-Led Multidisciplinary Conferences for Outpatient Parenteral Antimicrobial Therapy in Hospitalized Individuals with Complex Infections Who Use Drugs
At a Glance
Category
Detail
Condition
Complex infections requiring long-term intravenous antimicrobials in people who use drugs (PWUD)
Key Mechanisms
RN-led multidisciplinary care conferences (OPTIONS-DC) incorporating harm reduction, ethical principles, and patient preferences to guide treatment and discharge planning
Target Population
Hospitalized individuals with substance use disorders (SUD) and complex infections recommended for ≥10 days of IV antimicrobials
Care Setting
Hospital inpatient and outpatient settings, including outpatient parenteral antimicrobial therapy (OPAT)
Key Highlights
OPTIONS-DC is a standardized, RN-led multidisciplinary conference developed to improve discharge planning and treatment outcomes for PWUD with serious infections.
High antimicrobial course completion rate (75.1%) observed, with substantial out-of-hospital treatment completion and average 28.7 days of outpatient antimicrobial therapy.
Having a primary care provider at the time of conference significantly increased odds of treatment completion (OR 4.50).
Guideline-Based Recommendations
Diagnosis
Identify patients with substance use history requiring ≥10 days of IV antimicrobials for serious infections.
Management
Utilize multidisciplinary OPTIONS-DC conferences led by OPAT registered nurses to guide treatment and discharge planning.
Incorporate harm reduction principles and patient preferences into treatment decisions.
Consider socioeconomic factors such as housing stability, transportation, and communication access when planning OPAT.
Monitoring & Follow-up
Track antimicrobial course completion rates and out-of-hospital antimicrobial days.
Monitor for complications related to central line use, especially in patients with ongoing substance use.
Risks
Recognize stigma and discrimination as barriers to care and discharge planning.
Address risks of central line–associated bloodstream infections in patients who continue injection drug use.
Consider broader socioeconomic challenges beyond substance use that impact OPAT safety and adherence.
Patient & Prescribing Data
202 unique hospitalized patients with active substance use and complex infections
75.1% completed antimicrobial courses; 53.5% completed treatment outpatient; median antimicrobial duration 6 weeks; presence of primary care provider improved completion odds.
Clinical Best Practices
Lead discharge planning conferences with OPAT registered nurses to coordinate multidisciplinary input.
Embed harm reduction strategies and respect patient autonomy in treatment planning.
Engage primary care providers early to support treatment adherence and completion.
Address stigma proactively to improve patient trust and engagement.
Assess and mitigate socioeconomic barriers such as housing instability and transportation to facilitate safe OPAT.
by Alyse H Douglass, Heather Mayer, Kathleen Young, Amber C Streifel, Heather Franklin, Jina T Makadia, Liz Parkes-Perret, Luke C Strnad, Monica K Sikka
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