Evaluation of patient preferences for and cost effectiveness of community intravenous antibiotic services (CIVAS)

Description

Aims

1. Establish the types of Outpatient Parenteral Antimicrobial Therapy (OPAT) services available in England and identify barriers to the use of each service type
2. Evaluate patients’ preferences for different service models of delivering OPAT
3. Assess the cost-effectiveness of different service models of delivering OPAT

Method

Using a mixed methods approach the study included 7 centres providing OPAT and covering 4 main service models: hospital attendance, specialised nurse visiting at home, general nurse visiting at home, self or carer administration. The methods were:
- Systematic review
- Survey of health professionals
- Qualitative study of patient perceptions
- Quantitative analysis of patient preferences
- Cost effectiveness study
- Expert panel

Background

Intravenous (IV) antibiotic treatment was developed for patients in hospital, but for some years it has been accepted practice in most developed countries to provide this for patients living in the community, known as Outpatient Parenteral Antimicrobial Therapy (OPAT). There is evidence that it is safe, generally welcomed by patients and that there are opportunities for improved cost-effectiveness and increasing hospital capacity. However, OPAT has been slow to become established in the UK, with service provision being limited to clinical providers with effective, enthusiastic champions delivering a variety of different models of care. There is limited evidence available for NHS health care providers and commissioners to facilitate service development.

People

Minton, Leeds Teaching Hospitals NHS Acute Trust

Czoski-Murray, Leeds Institute of Health Sciences, University of Leeds

Meads, Leeds Institute of Health Sciences, University of Leeds

Hess, Institute of Transport Studies, University of Leeds

Vargas-Palacios, Leeds Institute of Health Sciences, University of Leeds

Mitchell, Leeds Institute of Health Sciences, University of Leeds

Wright, Leeds Institute of Health Sciences, University of Leeds

Hulme, Leeds Institute of Health Sciences, University of Leeds

Raynor, School of Healthcare, University of Leeds

Gregson, Leeds Community Healthcare Trust

Stanley, Bradford Teaching Hospitals NHS Foundation Trust

McLintock, Leeds Institute of Health Sciences, University of Leeds

Vincent, Leeds Teaching Hospitals NHS Acute Trust

Twiddy, Leeds Institute of Health Sciences, University of Leeds 

Funding body

NIHR HS & DR

Contact

Prof DK Theo Raynor d.k.raynor@leeds.ac.uk