Pineo Thomas, Goldman John D, Swartzentruber Greg, Kanderi Tejaswi, Qurashi Hafiz, Dimech Christina
Hospitalist, UPMC Central PA, Harrisburg Pennsylvania.
Infectious Disease, UPMC Central PA, Harrisburg Pennsylvania.
Drug Alcohol Depend Rep. 2021 Dec 20;2:100020. doi: 10.1016/j.dadr.2021.100020. eCollection 2022 Mar.
WHAT IS STOP OUD?: The STOP OUD project is an observational study on the use of long-acting buprenorphine (ublocade) and a amper resistant PICC clamp for utpatient IV antibiotic administration in atients with serious infections and pioid se isorder (STOP OUD).
The US opioid crisis is driving up serious infections related to intravenous drug use. These infections require prolonged courses of antibiotics, often resulting in lengthy hospital stays. Extended hospitalizations for monitored parenteral antibiotics for patients with opioid use disorder are challenging for patients, reduce bed capacity, and are associated with significant cost. This observational study reviews the administration of intravenous (IV) antibiotics in a monitored outpatient setting using long-acting injectable buprenorphine (Sublocade, Indivior Inc., North Chesterfield, VA) and a tamper resistant clamp in patients with opioid use disorder .
Long-acting buprenorphine and a tamper resistant clamp were used to treat patients with serious infections and opioid use disorder as outpatients.
Hospital days avoided were 30-days per STOP OUD project participant. Eleven of thirteen STOP OUD project participants completed their antibiotic courses as prescribed, there was no evidence of peripherally inserted central catheter (PICC) tampering, and they rated their care as a mean of 4.9/5 (SD 0.4). Institutional savings per STOP OUD patient was $33,000. Outpatient infusion costs were $9,300 for a net savings of $23,700 per STOP OUD project participant. Infections resolved in all participants.
The STOP OUD project reduced hospital length of stay for patients with opioid use disorder and serious infections, and had a favorable financial impact.
什么是“停止阿片类药物使用障碍(STOP OUD)”项目?“停止阿片类药物使用障碍(STOP OUD)”项目是一项观察性研究,旨在探讨长效丁丙诺啡(ublocade)和一种防篡改的经外周静脉穿刺中心静脉导管(PICC)夹在患有严重感染和阿片类药物使用障碍的门诊患者静脉注射抗生素治疗中的应用。
美国的阿片类药物危机导致与静脉注射吸毒相关的严重感染增多。这些感染需要长期使用抗生素治疗,常常导致住院时间延长。对于患有阿片类药物使用障碍的患者,在医院进行长时间的静脉抗生素监测治疗具有挑战性,会减少床位容量,且成本高昂。这项观察性研究评估了在门诊监测环境中,使用长效注射用丁丙诺啡(Sublocade,英迪维奥公司,弗吉尼亚州北切斯特菲尔德)和防篡改夹对患有阿片类药物使用障碍的患者进行静脉抗生素治疗的情况。
使用长效丁丙诺啡和防篡改夹对患有严重感染和阿片类药物使用障碍的患者进行门诊治疗。
每个“停止阿片类药物使用障碍(STOP OUD)”项目参与者避免住院天数达30天。13名“停止阿片类药物使用障碍(STOP OUD)”项目参与者中有11名按规定完成了抗生素疗程,没有证据表明经外周静脉穿刺中心静脉导管(PICC)被篡改,他们对护理的评分平均为满分5分中的4.9分(标准差0.4)。每个“停止阿片类药物使用障碍(STOP OUD)”患者为机构节省33,000美元。门诊输液费用为9,300美元,每个“停止阿片类药物使用障碍(STOP OUD)”项目参与者净节省23,700美元。所有参与者的感染均得到解决。
“停止阿片类药物使用障碍(STOP OUD)”项目缩短了患有阿片类药物使用障碍和严重感染患者的住院时间,并产生了有利的经济影响。