Evidence map›Paper›PMID 36600726›Full record

ArticleTherapeutic advances in infectious disease

Improving care for individuals with serious infections who inject drugs.

Colleen Kershaw, Jon D Lurie, Charles Brackett, Elias Loukas, Katie Smith, Sarah Mullins, Christine Gooley, Melissa Borrows, Shoshana Bardach, Amanda Perry and 6 more

Open access · goldAbstract read
In one paragraph

Article in Therapeutic advances in infectious disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

Colleen KershawDartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.ORCID https://orcid.org/0000-0001-8989-6146
Jon D LurieDartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Dartmouth College Geisel School of Medicine, Hanover, NH, USA.
Charles BrackettDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Elias LoukasDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Katie SmithDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Sarah MullinsDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Christine GooleyDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Melissa BorrowsNew England Life Care, South Portland, ME, USA.
Shoshana BardachThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Amanda PerryThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Elizabeth Carpenter-SongDepartment of Anthropology, Dartmouth College, Hanover, NH, USA.
H Samuel LandsmanDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Danielle PierottiVisiting Nurse and Hospice for Vermont and New Hampshire, White River Junction, VT, USA.
Ericka BergeronVisiting Nurse and Hospice for Vermont and New Hampshire, White River Junction, VT, USA.
Erin McMahonVisiting Nurse and Hospice for Vermont and New Hampshire, White River Junction, VT, USA.
Christine FinnDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Dartmouth College · USDartmouth–Hitchcock Medical Center · USDartmouth Institute for Health Policy and Clinical Practice · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Hospitalizations for serious infections requiring long-term intravenous (IV) antimicrobials related to injection drug use have risen sharply over the last decade. At our rural tertiary care center, opportunities for treatment of underlying substance use disorders were often missed during these hospital admissions. Once medically stable, home IV antimicrobial therapy has not traditionally been offered to this patient population due to theoretical concerns about misuse of long-term IV catheters, leading to discharges with suboptimal treatment regimens, lengthy hospital stays, or care that is incongruent with patient goals and preferences. Methods: A multidisciplinary group of clinicians and patients set out to redesign and improve care for this patient population through a health care innovation process, with a focus on increasing the proportion of patients who may be discharged on home IV therapy. Baseline assessment of current experience was established through retrospective chart review and extensive stakeholder analysis. The innovation process was based in design thinking and facilitated by a health care delivery improvement incubator. Results: The components of the resulting intervention included early identification of hospitalized people who inject drugs with serious infections, a proactive psychiatry consultation service for addiction management for all patients, a multidisciplinary care conference to support decision making around treatment options for infection and substance use, and care coordination/navigation in the outpatient setting with a substance use peer recovery coach and infectious disease nurse for patients discharged on home IV antimicrobials. Patients discharged on home IV therapy followed routine outpatient parenteral antimicrobial therapy (OPAT) protocols and treatment protocols for addiction with their chosen provider. Conclusion: An intervention developed through a design-thinking-based health care redesign process improved patient-centered care for people with serious infections who inject drugs.

Indexed as

injection drug useopioid use disorderoutpatient parenteral antimicrobial therapySubstance use disorders

Identifiers

PMID36600726
PMCPMC9806364
OpenAlexW4312818375

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.