Health-related quality of life and its association with outcomes of outpatient parenteral antibiotic therapy

• Published in: European journal of clinical microbiology & infectious diseases Vol. 39; no. 4; pp. 765 - 772
• Main Authors: Wee, Liang En, Sundarajoo, Mangaikarasi, Quah, Way-Fang, Farhati, Ahmad, Huang, Jie-ying, Chua, Ying-Ying
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2020; Springer Nature B.V
• Subjects: Antibiotics; Biomedical and Life Sciences; Biomedicine; Chi-square test; Complications; Internal Medicine; Medical Microbiology; Multivariate analysis; Original Article; Patients; Quality of life; Regression analysis; Risk; Statistical tests; Outpatient antibiotics service; Readmission; Complications; Quality of life
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-019-03787-6

While health-related quality of life (HRQoL) is an important component of patient-centred care, few studies have looked at the association between HRQoL and outcomes while on OPAT. From 2014 to 2017, we conducted a prospective cohort study of all patients referred to Singapore General Hospital’s (SGH) OPAT service. At baseline, we collected sociodemographic, clinical, and treatment-related factors for OPAT recipients. We also measured baseline HRQoL using the EuroQoL EQ5D-3 L. We evaluated the association between HRQoL and the following outcomes: complications experienced while on OPAT, early termination requiring readmission during planned course of OPAT, all-cause readmission 30 days after completion of OPAT, and return to work while on OPAT. We used chi-squared test for univariate analysis and cox regression for multivariate analysis. From 2014 to 2017, 1213 patients received OPAT at our centre. Of those, 13.2% (160/1213) developed complications. About 10% (132/1213) of patients were readmitted while on OPAT and OPAT was terminated early. Amongst patients who completed OPAT ( N  = 1081), about 3.6% (39/1081) were readmitted within 30 days after OPAT completion. About half (50.8%, 278/547) returned to work while on OPAT. On multivariate analysis, patients with perfect health-related quality of life (HRQoL) (adjusted relative risk, aRR  = 0.62, 95%CI = 0.45–0.85) were less likely to experience complications, had lower risk of OPAT termination ( aRR  = 0.57, 95%0.38–0.86), and were more likely to return to work while on OPAT ( aRR  = 1.94, 95%CI = 1.30–2.89). HRQoL at baseline was significantly associated with lower risk of complications and early OPAT termination, as well as greater likelihood of return to work while on OPAT.