Cargando…

A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”

Deep tissue infection is a serious sequela that often demands intravenous (IV) antibiotic treatment. With respect to IV drug users (IDU’s), research and lived experience demonstrates a trend of failed treatment outcomes, most notably associated with leaving hospital against medical advice (LAMA) pri...

Descripción completa

Detalles Bibliográficos
Autores principales: Jafari, Siavash, Joe, Ronald, Elliot, Danielle, Nagji, Ashnoor, Hayden, Sargent, Marsh, David C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320270/
https://www.ncbi.nlm.nih.gov/pubmed/25685126
http://dx.doi.org/10.1007/s11469-014-9511-4
_version_ 1782356095142985728
author Jafari, Siavash
Joe, Ronald
Elliot, Danielle
Nagji, Ashnoor
Hayden, Sargent
Marsh, David C.
author_facet Jafari, Siavash
Joe, Ronald
Elliot, Danielle
Nagji, Ashnoor
Hayden, Sargent
Marsh, David C.
author_sort Jafari, Siavash
collection PubMed
description Deep tissue infection is a serious sequela that often demands intravenous (IV) antibiotic treatment. With respect to IV drug users (IDU’s), research and lived experience demonstrates a trend of failed treatment outcomes, most notably associated with leaving hospital against medical advice (LAMA) prior to treatment completion, increased adverse outcomes and patient hardship. This paper examines an alternative model for delivering and completing IV antibiotic treatment to IDU’s in a community care setting. A retrospective study was designed to review client characteristics. A total of 33 in-depth interviews were conducted with clients, clinicians and with staff. The impact of treatment adherence and completion, as well as client satisfaction of care was explored. A total of 165 patients were admitted during the study period. Osteomyelitis was the primary cause for IV antibiotics. Risk of leaving AMA was significantly lower for community model (p value <0.0000). Qualitative narrative analysis is also described with respect to satisfaction, stigma and the need for better models of care. With lower rates of LAMA a community model ought to be considered on a wider scale for provision of comprehensive support for populations with complex underlying health needs.
format Online
Article
Text
id pubmed-4320270
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-43202702015-02-11 A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice” Jafari, Siavash Joe, Ronald Elliot, Danielle Nagji, Ashnoor Hayden, Sargent Marsh, David C. Int J Ment Health Addict Article Deep tissue infection is a serious sequela that often demands intravenous (IV) antibiotic treatment. With respect to IV drug users (IDU’s), research and lived experience demonstrates a trend of failed treatment outcomes, most notably associated with leaving hospital against medical advice (LAMA) prior to treatment completion, increased adverse outcomes and patient hardship. This paper examines an alternative model for delivering and completing IV antibiotic treatment to IDU’s in a community care setting. A retrospective study was designed to review client characteristics. A total of 33 in-depth interviews were conducted with clients, clinicians and with staff. The impact of treatment adherence and completion, as well as client satisfaction of care was explored. A total of 165 patients were admitted during the study period. Osteomyelitis was the primary cause for IV antibiotics. Risk of leaving AMA was significantly lower for community model (p value <0.0000). Qualitative narrative analysis is also described with respect to satisfaction, stigma and the need for better models of care. With lower rates of LAMA a community model ought to be considered on a wider scale for provision of comprehensive support for populations with complex underlying health needs. Springer US 2014-08-06 2015 /pmc/articles/PMC4320270/ /pubmed/25685126 http://dx.doi.org/10.1007/s11469-014-9511-4 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Article
Jafari, Siavash
Joe, Ronald
Elliot, Danielle
Nagji, Ashnoor
Hayden, Sargent
Marsh, David C.
A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”
title A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”
title_full A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”
title_fullStr A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”
title_full_unstemmed A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”
title_short A Community Care Model of Intravenous Antibiotic Therapy for Injection Drug Users with Deep Tissue Infection for “Reduce Leaving Against Medical Advice”
title_sort community care model of intravenous antibiotic therapy for injection drug users with deep tissue infection for “reduce leaving against medical advice”
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320270/
https://www.ncbi.nlm.nih.gov/pubmed/25685126
http://dx.doi.org/10.1007/s11469-014-9511-4
work_keys_str_mv AT jafarisiavash acommunitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT joeronald acommunitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT elliotdanielle acommunitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT nagjiashnoor acommunitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT haydensargent acommunitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT marshdavidc acommunitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT jafarisiavash communitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT joeronald communitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT elliotdanielle communitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT nagjiashnoor communitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT haydensargent communitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice
AT marshdavidc communitycaremodelofintravenousantibiotictherapyforinjectiondruguserswithdeeptissueinfectionforreduceleavingagainstmedicaladvice