Evaluation of a Remote Therapeutic Monitoring Device and Integrated Care Platform in Outpatient Parenteral Antimicrobial Therapy

BACKGROUND: Unplanned healthcare utilization events, including hospital readmissions and emergency room visits, are common in patients receiving outpatient parenteral antimicrobial therapy (OPAT). Little is known about patient adherence to therapy in this setting. This clinical trial evaluates the impact of a remote therapeutic monitoring (RTM) device with an integrated care platform on all-cause healthcare utilization in patients on OPAT. METHODS: This prospective, open-label, nonrandomized study enrolled patients discharged on OPAT to receive the IV Ensure RTM device compared to contemporaneous controls. The primary outcome was all-cause healthcare utilization, including hospital readmission or emergency room visit, assessed at day 90 after discharge. Adherence to antimicrobial therapy was evaluated in the intervention group. RESULTS: A total of 81 patients were enrolled in the intervention group, with 131 patients in the control group. Both groups had similar baseline and OPAT characteristics. On multivariate Cox regression analysis, the RTM intervention was associated with a 39% reduction in all-cause healthcare utilization by day 60 (adjusted hazard ratio, 0.61 [95% confidence interval, .38-.96]; P = .03]) and a 38% reduction by day 90 (0.62 [.40-.95]; P = .03). In the intervention group, the overall adherence reached a median of 94%, and 61.7% of patients maintained adherence of >90% throughout their OPAT course. CONCLUSIONS: An RTM device with an integrated care platform significantly reduced all-cause healthcare utilization events in patients on OPAT.