Effect of implementing a voluntary plan of care protocol in patients with substance use disorders and infective endocarditis Grace Cooksey, Robert Moye, Jerry Epps, Mahmoud Shorman, Michael Veve University of Tennessee Medical Center - Knoxville - Knoxville, TN
Background/Purpose: The national opioid epidemic has resulted in high rates of infections related to substance use disorders (SUD). Infective endocarditis (IE) is associated with increased rates of recurrent infection and high mortality when related to injection drug use. In August 2017, a voluntary protocol focused on safety, pain management, and addiction treatment was implemented for patients hospitalized with drug use associated infections. This study seeks to characterize the burden of illness related to IE secondary to SUD, and to assess the impact of a plan of care protocol for patients with SUD with IE.
Methodology: This single center, quasi experiment included hospitalized adults with active substance use and definite IEs from 1/2013 (pre-implementation) to 1/2019 (post-implementation). Patients with other IE risk factors, such as rheumatic or congenital heart disease, were excluded. Data collection included: patient demographics, substance abuse history, infection characteristics, antimicrobial therapy, disposition status, length of stay, readmission, and mortality. The primary outcome was to evaluate the impact of a plan of care protocol for patients with IE and SUD on all-cause readmission. Secondary outcomes included all-cause mortality and to define the prevalence, characteristics, and current treatment modalities for patients with SUD and IE.
Presentation Objective: Evaluate clinical outcomes after implementing a plan of care protocol for patients with SUD and infective endocarditis.
Self-Assessment: Does the utilization of a voluntary plan of care protocol improve clinical outcomes in patients with SUD and infective endocarditis when compared to those not enrolled in the protocol?
