Patient preferences for treatment of acute bacterial skin and skin structure infections in the emergency department

• Published in: BMC health services research 2018-12, Vol.18 (1), p.932-932, Article 932
• Main Authors: Almarzoky Abuhussain, Safa S, Burak, Michelle A, Kohman, Kelsey N, Jacknin, Gabrielle, Tart, Serina B, Hobbs, Athena L V, Adams, Danyel K, Nailor, Michael D, Keyloun, Katelyn R, Nicolau, David P, Kuti, Joseph L
• Format: Article
• Language: English
• Subjects: ABSSSI; Acute Disease; Ambulatory Care; Analysis; Anti-Bacterial Agents - therapeutic use; Antibiotic treatment; Antibiotics; Antimicrobial agents; Antimicrobial stewardship; Care and treatment; Dosage and administration; Emergency medical care; Emergency medicine; Emergency Service, Hospital; Enrollments; Female; Health services; Higher education; Hospital costs; Hospital emergency services; Hospitalization - statistics & numerical data; Humans; Infectious diseases; Infectious skin diseases; Informed consent; Male; Management; Medical records; Medicare; Middle Aged; Patient admissions; Patient Preference; Patient satisfaction; Preferences; Prospective Studies; R&D; Research & development; Sepsis; Skin Diseases, Bacterial - drug therapy; Staphylococcus infections
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-018-3751-0

Limited research has assessed patient preferences for treatment disposition and antibiotic therapy of acute bacterial skin and skin structure infection (ABSSSI) in the emergency department (ED). Understanding patient preference for the treatment of ABSSSI may influence treatment selection and improve satisfaction. A survey was conducted across 6 US hospital EDs. Patients with ABSSSI completed a baseline survey assessing preferences for antibiotic therapy (intravenous versus oral) and treatment location. A follow-up survey was conducted within 30-40 days after ED discharge to reassess preferences and determine satisfaction with care. A total of 94 patients completed both baseline and follow-up surveys. Sixty (63.8%) participants had a history of ABSSSI, and 69 (73.4%) were admitted to the hospital. Treatment at home was the most common preference reported on baseline and follow-up surveys. Patients with higher education were 82.2% less likely to prefer treatment in the hospital. Single dose intravenous therapy was the most commonly preferred antibiotic regimen on baseline and follow-up surveys (39.8 and 19.1%, respectively). Median satisfaction scores for care in the ED, hospital, home, and with overall antibiotic therapy were all 8 out of a maximum of 10. In these patients, the most common preference was for outpatient care and single dose intravenous antibiotics. Patient characteristics including higher education, younger age, and current employment were associated with these preferences. Opportunities exist for improving ABSSSI care and satisfaction rates by engaging patients and offering multiple treatment choices.