Challenges and drivers in the implementation of current practices in outpatient parenteral antimicrobial therapy: an international survey.

Background: Outpatient parenteral antimicrobial therapy (OPAT) is practised worldwide due to the benefits it provides to patients and healthcare systems. However, its full potential remains unrealized due to different implementation challenges. This study aims to identify barriers and facilitators that influence the routine implementation of current practices in the OPAT programme. Methods: An international, multi-centre electronic survey was conducted among healthcare facilities providing OPAT services in Australia, Malaysia, the UK, Spain, Turkey and Middle East countries. The survey instrument was developed based on the Consolidated Framework for Implementation Research and guideline recommendations for OPAT. Statistical analyses were performed using SPSS version 30. Results: The survey received responses from 150 healthcare facilities across 10 countries offering OPAT services. The majority (11 879.7%) of healthcare facilities implement OPAT through a formal structure. The majority (92.2%) had a designated team lead. Most facilities (12 685.7%) reported the implementation of antimicrobial toxicity monitoring. Only 58 facilities (39.5%) reported implementation of regular audits of their OPAT programmes. The most reported barriers to OPAT implementation included wide geographic distribution of patients (50.7%), lack of financial support (42.7%) and the dosing frequency of antimicrobials (40.6%). Facilitators to OPAT implementation include hospital bed savings, clinical safety and efficacy, cost-effectiveness and patient satisfaction. Conclusions: The majority of healthcare facilities implement OPAT through a formal structure. However, several challenges continue to hinder its routine implementation. Ongoing efforts to address implementation barriers are crucial for strengthening existing services and supporting the expansion of new services.