Frequency of outpatient antibiotic prescription on discharge to hospice care

Jon P. Furuno, Brie N. Noble, Kristi N. Horne, Jessina C. McGregor, Miriam R. Elman, David T. Bearden, Eric Walsh, Erik Fromme

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The use of antibiotics is common in hospice care despite limited evidence that it improves symptoms or quality of life. Patients receiving antibiotics upon discharge from a hospital may be more likely to continue use following transition to hospice care despite a shift in the goals of care. We quantified the frequency and characteristics for receiving a prescription for antibiotics on discharge from acute care to hospice care. This was a cross-sectional study among adult inpatients (≥18 years old) discharged to hospice care from Oregon Health & Science University (OHSU) from 1 January 2010 to 31 December 2012. Data were collected from an electronic data repository and from the Department of Care Management. Among 62,792 discharges, 845 (1.3%) patients were discharged directly to hospice care (60.0% home and 40.0% inpatient). Most patients discharged to hospice were >65 years old (50.9%) and male (54.6%) and had stayed in the hospital for ≤7 days (56.6%). The prevalence of antibiotic prescription upon discharge to hospice was 21.1%. Among patients discharged with an antibiotic prescription, 70.8% had a documented infection during their index admission. Among documented infections, 40.3% were bloodstream infections, septicemia, or endocarditis, and 38.9% were pneumonia. Independent risk factors for receiving an antibiotic prescription were documented infection during the index admission (adjusted odds ratio [AOR] = 7.00; 95% confidence interval [95% CI] = 4.68 to 10.46), discharge to home hospice care (AOR = 2.86; 95% CI = 1.92 to 4.28), and having a cancer diagnosis (AOR = 2.19; 95% CI = 1.48 to 3.23). These data suggest that a high proportion of patients discharged from acute care to hospice care receive an antibiotic prescription upon discharge.

Original languageEnglish (US)
Pages (from-to)5473-5477
Number of pages5
JournalAntimicrobial Agents and Chemotherapy
Volume58
Issue number9
DOIs
StatePublished - 2014

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Hospice Care
Prescriptions
Outpatients
Anti-Bacterial Agents
Hospices
Odds Ratio
Confidence Intervals
Infection
Inpatients
Patient Care Planning
Home Care Services
Endocarditis
Sepsis
Pneumonia
Cross-Sectional Studies
Quality of Life
Health

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Infectious Diseases

Cite this

Furuno, J. P., Noble, B. N., Horne, K. N., McGregor, J. C., Elman, M. R., Bearden, D. T., ... Fromme, E. (2014). Frequency of outpatient antibiotic prescription on discharge to hospice care. Antimicrobial Agents and Chemotherapy, 58(9), 5473-5477. https://doi.org/10.1128/AAC.02873-14

Frequency of outpatient antibiotic prescription on discharge to hospice care. / Furuno, Jon P.; Noble, Brie N.; Horne, Kristi N.; McGregor, Jessina C.; Elman, Miriam R.; Bearden, David T.; Walsh, Eric; Fromme, Erik.

In: Antimicrobial Agents and Chemotherapy, Vol. 58, No. 9, 2014, p. 5473-5477.

Research output: Contribution to journalArticle

Furuno, JP, Noble, BN, Horne, KN, McGregor, JC, Elman, MR, Bearden, DT, Walsh, E & Fromme, E 2014, 'Frequency of outpatient antibiotic prescription on discharge to hospice care', Antimicrobial Agents and Chemotherapy, vol. 58, no. 9, pp. 5473-5477. https://doi.org/10.1128/AAC.02873-14
Furuno, Jon P. ; Noble, Brie N. ; Horne, Kristi N. ; McGregor, Jessina C. ; Elman, Miriam R. ; Bearden, David T. ; Walsh, Eric ; Fromme, Erik. / Frequency of outpatient antibiotic prescription on discharge to hospice care. In: Antimicrobial Agents and Chemotherapy. 2014 ; Vol. 58, No. 9. pp. 5473-5477.
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