scholarly journals Association of laboratory test result availability and rehospitalizations in an outpatient parenteral antimicrobial therapy programme

2013 ◽  
Vol 69 (1) ◽  
pp. 228-233 ◽  
Author(s):  
D. Huck ◽  
J. P. Ginsberg ◽  
S. M. Gordon ◽  
A. S. Nowacki ◽  
S. J. Rehm ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Antimicrobial Therapy ◽  
Laboratory Test Result ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Test Result ◽  
Therapy Programme

scholarly journals A Formal Outpatient Parenteral Antimicrobial Therapy Program for Patients with Solid Tumors

2021 ◽  
Author(s):  
Alison Robins ◽  
Emma Dishner ◽  
Patrick McDaneld ◽  
Meagan Rowan ◽  
Jalen Bartek ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Solid Tumors ◽  
Antimicrobial Therapy ◽  
Statistical Significance ◽  
Laboratory Test Result ◽  
Emergency Center ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Therapy Program ◽  
Test Result

Abstract Background and Objectives: Outpatient parenteral antimicrobial therapy (OPAT) for infections has been in use for nearly 40 years, and although it has been found safe and efficacious, its use has been studied primarily among otherwise healthy patients. We aimed to develop and evaluate an OPAT program for patients with cancer, particularly solid tumors. Methods: We implemented multiple quality improvement interventions between June 2018 and January 2020. We retrospectively and prospectively collected data on demographics, the quality of infectious diseases (ID) physician consultation notes, rates of laboratory test result monitoring, ID clinic follow-up, and 30-day outcomes, including unplanned OPAT-related readmissions, OPAT-related emergency center visits, and deaths. Results: Completeness of ID provider notes improved from a baseline of 77% to 100% (p<.0001) for antimicrobial recommendations, 75% to 97% (p<.0001) for follow-up recommendations, and 19% to 98% (p<.0001) for laboratory test result monitoring recommendations. Completion of laboratory tests increased from a baseline rate of 24% to 56% (p=.027). Thirty-day unplanned OPAT-related readmission, ID clinic follow-up, 30-day emergency center visit, and death rates improved without reaching statistical significance. Conclusions: Sustained efforts, multiple interventions, and multidisciplinary engagement can improve laboratory test result monitoring among solid tumor patients discharged with OPAT. Although demonstrating a decrease in unplanned readmissions through institution of a formal OPAT program among patients with solid malignancies may be more difficult compared with the general population, the program may still result in improved safety.

scholarly journals Improving the safety of outpatient parenteral antimicrobial therapy for patients with solid tumors

2021 ◽  
Author(s):  
Alison Robins ◽  
Emma Dishner ◽  
Patrick McDaneld ◽  
Meagan Rowan ◽  
Jalen Bartek ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Solid Tumors ◽  
Antimicrobial Therapy ◽  
Statistical Significance ◽  
Laboratory Test Result ◽  
Emergency Center ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Quality Improvement Interventions ◽  
Test Result

Abstract Background and objectives Outpatient parenteral antimicrobial therapy (OPAT) for infections has been in use for nearly 40 years, and although it has been found safe and efficacious, its use has been studied primarily among otherwise healthy patients. We aimed to develop and evaluate an OPAT program for patients with cancer, particularly solid tumors. Methods We implemented multiple quality improvement interventions between June 2018 and January 2020. We retrospectively and prospectively collected data on demographics, the completeness of infectious diseases (ID) physician consultation notes, rates of laboratory test result monitoring, ID clinic follow-up, and 30-day outcomes, including unplanned OPAT-related readmissions, OPAT-related emergency center visits, and deaths. Results Completeness of ID provider notes improved from a baseline of 77 to 100% (p < .0001) for antimicrobial recommendations, 75 to 97% (p < .0001) for follow-up recommendations, and 19 to 98% (p < .0001) for laboratory test result monitoring recommendations. Completion of laboratory tests increased from a baseline rate of 24 to 56% (p = .027). Thirty-day unplanned OPAT-related readmission, ID clinic follow-up, 30-day emergency center visit, and death rates improved without reaching statistical significance. Conclusions Sustained efforts, multiple interventions, and multidisciplinary engagement can improve laboratory test result monitoring among solid tumor patients discharged with OPAT. Although demonstrating a decrease in unplanned readmissions through institution of a formal OPAT program among patients with solid malignancies may be more difficult compared with the general population, the program may still result in improved safety.

scholarly journals Utility of Laboratory Test Result Monitoring in Patients Taking Oral Terbinafine or Griseofulvin for Dermatophyte Infections

2018 ◽  
Vol 154 (12) ◽  
pp. 1409 ◽  
Author(s):  
Deirdre A. Stolmeier ◽  
Hannah B. Stratman ◽  
Thomas J. McIntee ◽  
Erik J. Stratman
Keyword(s):  
Laboratory Test ◽  
Laboratory Test Result ◽  
Test Result ◽  
Oral Terbinafine

scholarly journals The Impact of Continuous Improvement of Laboratory Test Result Comments on Requests for Consultation

2015 ◽  
Vol 144 (suppl 2) ◽  
pp. A200-A200
Author(s):  
Robert Schmidt ◽  
Jeanne Panlener ◽  
Suzanne Carasso ◽  
Jerry Hussong
Keyword(s):  
Laboratory Test ◽  
Continuous Improvement ◽  
Laboratory Test Result ◽  
The Impact ◽  
Test Result

scholarly journals Impact of Continuous Improvement of Laboratory Test Result Comments on Requests for Consultation: Table 1

2016 ◽  
Vol 145 (5) ◽  
pp. 666-670 ◽  
Author(s):  
Robert L. Schmidt ◽  
Jeanne J. Panlener ◽  
Suzanne M. Carasso ◽  
Jerry W. Hussong
Keyword(s):  
Laboratory Test ◽  
Continuous Improvement ◽  
Laboratory Test Result ◽  
Test Result

scholarly journals A network medicine approach to investigation and population-based validation of disease manifestations and drug repurposing for COVID-19

PLoS Biology ◽  
2020 ◽  
Vol 18 (11) ◽  
pp. e3000970 ◽  
Author(s):  
Yadi Zhou ◽  
Yuan Hou ◽  
Jiayu Shen ◽  
Reena Mehra ◽  
Asha Kallianpur ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Single Cell ◽  
Laboratory Test Result ◽  
Host Protein ◽  
Smoking History ◽  
Molecular Profile ◽  
Network Medicine ◽  
Sequencing Data ◽  
Human Interactome ◽  
Test Result

The global coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to unprecedented social and economic consequences. The risk of morbidity and mortality due to COVID-19 increases dramatically in the presence of coexisting medical conditions, while the underlying mechanisms remain unclear. Furthermore, there are no approved therapies for COVID-19. This study aims to identify SARS-CoV-2 pathogenesis, disease manifestations, and COVID-19 therapies using network medicine methodologies along with clinical and multi-omics observations. We incorporate SARS-CoV-2 virus–host protein–protein interactions, transcriptomics, and proteomics into the human interactome. Network proximity measurement revealed underlying pathogenesis for broad COVID-19-associated disease manifestations. Analyses of single-cell RNA sequencing data show that co-expression of ACE2 and TMPRSS2 is elevated in absorptive enterocytes from the inflamed ileal tissues of Crohn disease patients compared to uninflamed tissues, revealing shared pathobiology between COVID-19 and inflammatory bowel disease. Integrative analyses of metabolomics and transcriptomics (bulk and single-cell) data from asthma patients indicate that COVID-19 shares an intermediate inflammatory molecular profile with asthma (including IRAK3 and ADRB2). To prioritize potential treatments, we combined network-based prediction and a propensity score (PS) matching observational study of 26,779 individuals from a COVID-19 registry. We identified that melatonin usage (odds ratio [OR] = 0.72, 95% CI 0.56–0.91) is significantly associated with a 28% reduced likelihood of a positive laboratory test result for SARS-CoV-2 confirmed by reverse transcription–polymerase chain reaction assay. Using a PS matching user active comparator design, we determined that melatonin usage was associated with a reduced likelihood of SARS-CoV-2 positive test result compared to use of angiotensin II receptor blockers (OR = 0.70, 95% CI 0.54–0.92) or angiotensin-converting enzyme inhibitors (OR = 0.69, 95% CI 0.52–0.90). Importantly, melatonin usage (OR = 0.48, 95% CI 0.31–0.75) is associated with a 52% reduced likelihood of a positive laboratory test result for SARS-CoV-2 in African Americans after adjusting for age, sex, race, smoking history, and various disease comorbidities using PS matching. In summary, this study presents an integrative network medicine platform for predicting disease manifestations associated with COVID-19 and identifying melatonin for potential prevention and treatment of COVID-19.

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