Outpatient parenteral antimicrobial therapy delivery, readmission rates, and multidisciplinary teams: a scoping review of the impact of published quality indicators.

Background: Outpatient parenteral antimicrobial therapy (OPAT) reduces hospitalization, yet poor standardization and implementation contribute to readmission rates near 25%. The Infectious Diseases Society of America recommends structured and multidisciplinary OPAT programs. Twelve quality indicators, spanning organization, initiation, continuation, and outcome domains, have been proposed to improve OPAT delivery. Our scoping review assessed associations between reported OPAT quality indicators and patient readmission. Methods: We searched PubMed, Embase, Cochrane CENTRAL, Web of Science, and Google Scholar from database inception through May 1, 2025, for studies of adults discharged on OPAT, managed by multidisciplinary teams, and reporting readmission rates. Data included presence of each quality indicator, team composition, and readmission rates. Readmission was categorized as low (<10%) or high (≥10%). Results: Of 2,610 studies screened, 18 (5,027 patients) met criteria. The median readmission rate was 11.3 (IQR 8-20). All studies reported a structured OPAT program and formal OPAT team. Initial patient assessment by a competent team member was more common in studies with lower readmissions. Reporting more indicators (range 4-11) did not significantly correlate with fewer readmissions. Organization and initiation indicators were reported more frequently than continuation and outcome indicators. All programs included an infectious diseases physician; 94% included nurses, 55% pharmacists, 28% social workers, and 11% hospitalists. Conclusions: Higher quantity of reported indicators did not predict fewer readmissions. Future research should explore team engagement, including potential roles of hospitalists and social workers to strengthen care transitions, and the impact of continuation and outcome indicators on readmissions.