What is it about?

Some children with serious bacterial infections may be able to have their antibiotic medicine given to them intravenously at home. The technical term for this is outpatient parenteral antimicrobial therapy or OPAT, for short. For most children this means that a nurse comes out once a day to give the medicine and to check that the child is progressing well. Although there is evidence that OPAT is safe for children there is very little information about what children and parents think about having this treatment at home. In this paper we report on the findings from interview with 10 mothers, 2 fathers and 1 child about their experience of having OPAT. The main benefit of OPAT was that parents said their child was able to 'recuperate' better at home and that the stress for the whole family was reduced. Parents felt that they were better able to return to a more normal routine for their child when they were at home, compared to being in hospital. We found out that for most parents, the benefits of being 'at-home' outweighed any of the challenges that they experienced. These challenges included worries about the 'line' that was used to give the medication, having to be at home when the nurses called to give the medication. However, a few parents said they would have preferred to have stayed in hospital. Good communication and clear information about OPAT was important to ensure parents felt confident and secure in their child having their antibiotic medicine given to them intravenously at home.

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Why is it important?

Despite the challenges inherent in OPAT, being at-home was perceived by most parents to be the best place for treatment, in terms of comfort and recuperation. Improvements to preparation and information about OPAT, the medicines and negotiation of treatment times are important ways of improving the experience of parents and children being at-home on OPAT. Adopting an improved 'whole-system' approach focusing on the child being able to live a full life on OPAT would be beneficial

Perspectives

This article has created evidence about parents' experiences of their child being able to be treated at home rather than in hospital. Although there was plenty of evidence about cost effectiveness about this treatment, we did not know how much stress and strain parents experienced or what the rewards and benefits were. This study is an important contribution to our understanding and can help improve clinical services.

Professor Bernie Carter
Edge Hill University

Read the Original

This page is a summary of: Being ‘at-home’ on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents’ experiences of paediatric OPAT, Archives of Disease in Childhood, September 2019, BMJ,
DOI: 10.1136/archdischild-2019-317629.
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