An observational study on the use of long acting buprenorphine (S ublocade) and a T amper resistant PICC for O utpatient IV antibiotic administration in P atients with serious infections and O pioid U se D isorder; The STOP OUD project

Thomas Pineo; John D Goldman; Greg Swartzentruber; Tejaswi Kanderi; Hafiz Qurashi; Christina Dimech

doi:10.1016/j.dadr.2021.100020

An observational study on the use of long acting buprenorphine (S ublocade) and a T amper resistant PICC for O utpatient IV antibiotic administration in P atients with serious infections and O pioid U se D isorder; The STOP OUD project

Drug Alcohol Depend Rep. 2021 Dec 20:2:100020. doi: 10.1016/j.dadr.2021.100020. eCollection 2022 Mar.

Authors

Thomas Pineo¹, John D Goldman², Greg Swartzentruber³, Tejaswi Kanderi⁴, Hafiz Qurashi⁵, Christina Dimech⁵

Affiliations

¹ Hospitalist, UPMC Central PA, Harrisburg Pennsylvania.
² Infectious Disease, UPMC Central PA, Harrisburg Pennsylvania.
³ Toxicology and Emergency Medicine, UPMC Central PA, Harrisburg Pennsylvania.
⁴ Hospitalist, Penn State Hershey, Harrisburg Pennsylvania.
⁵ UPMC Central PA, Harrisburg Pennsylvania.

Abstract

What is stop oud?: The STOP OUD project is an observational study on the use of long-acting buprenorphine (Sublocade) and a Tamper resistant PICC clamp for Outpatient IV antibiotic administration in Patients with serious infections and Opioid Use Disorder (STOP OUD).

Background: The US opioid crisis is driving up serious infections related to intravenous drug use. These infections require prolonged courses of antibiotics, often resulting in lengthy hospital stays. Extended hospitalizations for monitored parenteral antibiotics for patients with opioid use disorder are challenging for patients, reduce bed capacity, and are associated with significant cost. This observational study reviews the administration of intravenous (IV) antibiotics in a monitored outpatient setting using long-acting injectable buprenorphine (Sublocade, Indivior Inc., North Chesterfield, VA) and a tamper resistant clamp in patients with opioid use disorder .

Methods: Long-acting buprenorphine and a tamper resistant clamp were used to treat patients with serious infections and opioid use disorder as outpatients.

Results: Hospital days avoided were 30-days per STOP OUD project participant. Eleven of thirteen STOP OUD project participants completed their antibiotic courses as prescribed, there was no evidence of peripherally inserted central catheter (PICC) tampering, and they rated their care as a mean of 4.9/5 (SD 0.4). Institutional savings per STOP OUD patient was $33,000. Outpatient infusion costs were $9,300 for a net savings of $23,700 per STOP OUD project participant. Infections resolved in all participants.

Conclusions: The STOP OUD project reduced hospital length of stay for patients with opioid use disorder and serious infections, and had a favorable financial impact.

Keywords: Intravenous drug use; buprenorphine; line protection clamp; medication for opioid use disorder; outpatient antibiotic therapy.