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796. Improving Clostridioides difficile Infection Treatment and Outcomes Using a Web-based Tool to Support a Care Coordination Intervention

BACKGROUND: Clostridioides difficile infection (CDI) is a highly burdensome disease, affecting 500,000 Americans each year. Despite extensive efforts to prevent and treat CDI, variability remains in the treatment guidelines, particularly as new medications are released. Treating CDI is particularly...

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Detalles Bibliográficos
Autores principales: McKoy, J Nikki, Biondolillo, Madeleine, House, John A, Kunz, Emily, Safo, Stella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777646/
http://dx.doi.org/10.1093/ofid/ofaa439.986
Descripción
Sumario:BACKGROUND: Clostridioides difficile infection (CDI) is a highly burdensome disease, affecting 500,000 Americans each year. Despite extensive efforts to prevent and treat CDI, variability remains in the treatment guidelines, particularly as new medications are released. Treating CDI is particularly difficult, as approximately 25% of infected individuals experience recurrent CDI (rCDI). METHODS: We used a pre-post design to measure the impact of an intervention on rCDI, CDI readmission, and guideline-adherent treatment rates in adult patients who were admitted with or contracted CDI in the hospital. The intervention included the following: • Web-based performance platform delivering education and care coordination support • CDI care coordination for 8 weeks post-discharge (Figure 1) • Education and tools for addressing CDI guidelines, workflow needs, and patient engagement • Best practice sharing through peer-to-peer discussion calls Patient Contacts [Image: see text] RESULTS: Among the 77 patients consented in the Pre-Intervention period, 12 (15.6%) patients reported a recurrence of CDI, compared to 6 (15.4%) of the 39 Intervention patients who provided a response (P = 0.98). While a total of 55 patients were consented in the Intervention period, none reported a readmission for CDI, however 9 (11.7%) of Pre-Intervention patients reported a readmission for CDI (P = 0.03). There was a significant difference (P < 0.001) between the use of appropriate treatment, as defined by the 2018 SHEA/IDSA guidelines, between the Pre-Intervention and Intervention groups (55.8% vs. 94.3%). CONCLUSION: A comprehensive multi-disciplinary team approach to preventing rCDI, including post-discharge care coordination, provides support to patients and caregivers. Future research is needed to evaluate how web-based tools, like those used in this study, could engage patients in the management of CDI and rCDI. Interventions aimed at improving the care of these patients may reduce recurrences and rehospitalizations. DISCLOSURES: All Authors: No reported disclosures