CP-018 Outpatient parenteral antibiotic therapy (OPAT) – a qualitative study of patient perspectives in those choosing not to self-administer

Background
OPAT is a well established treatment for administration of intravenous (IV) antibiotics, and models of administration include home self-administration. Despite this offering advantages, statistics indicate that less patients in the research centre home self-administer compared with other national centres.1

Purpose
To explore the understanding and beliefs around home self-administration in a cohort of patients who choose not to home self-administer.

Material and methods
Qualitative, semi-structured, in-depth interviews were undertaken with a purposive sample of patients. Included patients were attending the outpatient clinic for IV antibiotic administration, had received more than 7 days of antibiotics and were aged 16 years and over. A semi-structured interview schedule, underpinned by the Theoretical Domains Framework (TDF), was developed. Interviews were audio recorded and transcribed verbatim. Data were analysed thematically by sever researchers using the TDF as the coding framework. The study was approved by the appropriate ethics committees.

Results
20 participants were approached and all agreed to participate. 13 were male, with a mean age of 54 years (SD 17.6). Themes mapped almost all of the TDF behavioural determinants. The key behavioural determinants were knowledge, beliefs about capabilities, beliefs about consequences and environment, context and resources. Patients appeared to be very knowledgeable about their disease and its management, and had good procedural knowledge for administration of IV antibiotics. Most were very positive about their capabilities to home self-administer, provided they were given the appropriate support, training and confidence. However, few had any knowledge about the options available to them to administer IV antibiotics, particularly home self-administration.

Conclusion
The main barrier to not self-administering appears to be the lack of knowledge about options available for IV antibiotic administration. Although patients may have been given this knowledge, there is an opportunity to review practice and develop an intervention to educate, train and support patients with home self-administration.