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Development and implementation of a pharmacist-managed outpatient parenteral antimicrobial therapy program
Eun Kyoung Chung1, Cole B Beeler1, Eva W Muloma1
1Eun Kyoung Chung, Pharm.D., Ph.D., is Assistant Professor, Clinical Pharmacy/Pharmacotherapy, Department of Pharmacy, Kyung Hee University College of Pharmacy, Seoul, South Korea; at the time of writing she was a graduate student, Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafeyette, IN. Cole B. Beeler, M.D., is Infectious Diseases Fellow, Indiana University School of Medicine, Indianapolis; at the time of writing he was Chief Internal Medical Resident, Eskenazi Health (formerly Wishard Health Services), Indianapolis. Eva W. Muloma, M.D., is Infectious Diseases Physician, Indiana University Medical Group, and Co-Director, Outpatient Parenteral Antimicrobial Therapy (OPAT) Program, Eskenazi Health. Danielle Osterholzer, M.D., is Infectious Diseases Faculty, Hurley Medical Center, Flint, MI; at the time of writing she was Assistant Clinical Professor of Medicine and Pediatrics, Division of Infectious Diseases, Indiana University School of Medicine, and Section Chief of Infectious Diseases, Eskenazi Health. Kendra M. Damer, Pharm.D., is Associate Professor, Department of Pharmacy Practice, Butler University College of Pharmacy and Health Sciences, Indianapolis; at the time of writing she was Assistant Professor of Pharmacy Practice, Butler University College of Pharmacy and Health Sciences, and Infectious Diseases Clinical Pharmacy Specialist, Eskenazi Health. Sharon M. Erdman, Pharm.D., is Clinical Professor, Department of Pharmacy Practice, Purdue University College of Pharmacy, and Infectious Diseases Clinical Pharmacist and Co-Director, OPAT Program, Eskenazi Health.
Purpose:
The development and implementation of a pharmacist-managed outpatient parenteral antimicrobial therapy (OPAT) program in a county teaching hospital are described.
Summary:
A pharmacist-managed OPAT program was developed and implemented at a county teaching hospital to provide consistent evaluation, approval, and monitoring of patients requiring OPAT for the treatment of infection. The developmental and implementation stages of the OPAT program included (1) a needs assessment, (2) the identification of resources necessary for program operation, (3) delineation of general OPAT program operations and activities of individual OPAT clinicians, (4) the development of patient selection criteria, including a plan of care algorithm, and (5) acquisition of administrative support to approve the program. In this program, the OPAT pharmacist plays an integral role in the management and oversight of OPAT patients, working under a collaborative agreement with infectious diseases physicians. The OPAT pharmacist assists with appropriate patient and regimen selection, confirmation of orders on discharge, assuring that laboratory tests for safety surveillance are performed and evaluated, performing routine monitoring for adverse events and line complications, and assuring the removal of the vascular access device upon the completion of OPAT.
Conclusion:
The OPAT program provides structured monitoring, patient follow-up, and led to improvements in patient outcome with minimization of treatment and line-related adverse events.
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