1134 - Substance Use Disorder Patients' Perspectives of a Multidisciplinary Antimicrobial Infusion Service

Background: Injection drug use is associated with infectious diseases such as endocarditis and osteomyelitis requiring prolonged intravenous (IV) antimicrobial therapy.  Few programs offer simultaneous inpatient infectious disease and addiction treatment.  WVU Medicine implemented a multidisciplinary Infusion Service (IS) to provide IV antimicrobial therapy while treating substance use disorder.  From 2017 through 2019, IS cared for over 840 patients.  The aim of this study was to evaluate IS by assessing patients’ perspectives of overall experience, interactions with healthcare providers, and preparation for continued recovery from substance use.

Methods: Adults ≥ 18 and < 90 years-old with substance use disorder on IS between November 2019 and May 2020 were eligible.  Demographic, substance use, and infectious diseases data were obtained by chart review.  Confidential surveys with questions about overall experience, interactions with healthcare providers, and preparation for continued recovery were administered during the first week after transfer to IS and again the week of discharge.

Results: Forty-two patients completed 39 initial and 12 follow up surveys.  All used injection drugs, 85.7% (36/42) used opioids and 66.7% (28/42) used methamphetamine.  Endocarditis was most common infection (61.9% (26/42)), with Staphylococcus aureus most often isolated (59.5% (25/42)).  IS experience and care for infection were excellent or good in 97.4% (38/39) initial and 100% (12/12) follow up surveys.  During IS, patients did not perceive being treated differently due to substance use in 94.9% (37/39) initial and 83.3% (10/12) follow up surveys.  Before IS, patients perceived being treated differently in 84.6% (33/39) initial and 100% (12/12) follow up surveys.  Patients felt IS would help with continued recovery in 84.6% (33/39) initial and 100% (12/12) follow up surveys.

Conclusion: According to patients’ perspectives, IS is effective in creating a positive overall healthcare experience, reducing stigma associated with substance use, and preparing patients for continued recovery after discharge.  This study supports combining inpatient infectious disease and addiction therapy.  Infectious diseases providers should be educated about this multidisciplinary approach.