Implementing a Collaborative Approach to Caring for Patients With Substance Use Disorders Requiring Outpatient...

Area of Science:

• Infectious Diseases
• Public Health
• Healthcare Management

Background:

• Injection-related infections (IRI) frequently necessitate prolonged outpatient parenteral antimicrobial therapy (OPAT).
• Patients with substance use disorders (SUD) often experience suboptimal post-discharge care when receiving OPAT for IRI.
• A gap exists in integrated care models for patients with SUD requiring OPAT.

Purpose of the Study:

• To describe the implementation and outcomes of a novel program integrating OPAT and SUD support services at skilled nursing facilities (SNFs).
• To evaluate the impact of this integrated model on clinical outcomes for patients with SUD and IRI.

Main Methods:

• Retrospective chart review of patients with a history of SUD discharged to SNFs between 2021-2023.
• Comparison of outcomes between patients discharged to a pilot SNF offering integrated care and those discharged to non-pilot SNFs.
• Descriptive statistics used to analyze sociodemographic variables, OPAT outcomes, and SUD outcomes.

Main Results:

• Patients discharged to the pilot SNF (n=26) attended infectious disease appointments more frequently (73% vs. 51%) compared to alternative SNFs (n=172).
• The pilot program group showed lower 30-day hospital readmission rates (15% vs. 21%) and infection relapse rates (8% vs. 22%).
• Rates of self-directed discharge were comparable between the pilot and alternative SNF groups.

Conclusions:

• The co-location of OPAT and SUD support services within SNFs represents a successful, innovative approach to managing complex patient needs.
• This integrated model demonstrates potential for improving clinical outcomes, including reduced readmissions and infection relapses.
• Further research is warranted to assess long-term outcomes and explore sustainable strategies for scaling this intervention.