1006. High Adherence and Cost Savings with Home OPAT Provided through Infectious Disease Physician Office Infusion Centers

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Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) has been shown to be safe and effective for self-administration but can lead to non-adherence without supervision. A physician office infusion center (POIC) with pharmacy services provides a unique opportunity to impact adherence and OPAT management. Patients (pts) typically come to the POIC weekly for catheter care, laboratory collection, medication pick-up and as needed provider visits. Often, close provider oversight allows for de-escalation of OPAT. We evaluated adherence to therapy, visits and associated cost saving in pts receiving self-administered OPAT through POICs. Methods Pts receiving home OPAT in 2021 were randomly selected from participating sites based on annual pt volume. Adherence was assessed as % of OPAT doses dispensed vs. doses missed. Frequency of office visits for routine catheter care and labs along with OPAT completion were collected. Cost savings were calculated in days of OPAT saved due to therapy de-escalation and response to therapy, based upon published daily costs of OPAT. Pt characteristics, OPAT duration, infection type and regimen were captured. Results A total of 125 of 2180 pts from 13 POICs nationally were included (mean age 50±18 years, 52% male). Mean OPAT duration was 38±9 days. Predominant infections were bone and joint (38%), complicated skin (18%), intra-abdominal (15%) and bacteremia (14%). The most common antimicrobials were cephalosporins (54%) with 20 pts self-administering ≥2 drugs. Pts had a mean of 6±3 POIC visits during the therapy course with completion as scheduled in 703/706 visits (99.6%). OPAT was completed as planned in 118 pts (94%), with discontinuations for adverse events (n=3), hospitalization (n=2), or non-adherence (n=2). Overall adherence rate was 99.3% with 51 missed of 7315 doses dispensed. De-escalation during OPAT saved 533 doses equating to 307 days of OPAT (2.4 days/pt). Based on an average daily OPAT cost of $140, this saved $42,980 in the randomized cohort and an estimated $749,571 annually in the entire population. Conclusion Home OPAT through an ID POIC was associated with a very high rate of adherence and compliance to scheduled visits in pts. ID oversight resulted in healthcare cost savings through onsite antimicrobial stewardship and therapy management. Disclosures Lucinda J. Van Anglen, PharmD, Merck & Co.: Grant/Research Support|Paratek: Grant/Research Support.