Improving the Care of Patients with Serious Infections and Injection Drug Use

Abstract

People who inject drugs (PWID) face substantial barriers to optimal treatment of serious infections, including high rates of self-directed discharge, fragmented follow-up, and limited eligibility for outpatient parenteral antimicrobial therapy (OPAT). A needs assessment at Dartmouth Health identified significant gaps in addiction treatment engagement, social support, and access to safe home environments. A multidisciplinary intervention was implemented incorporating Behavioral Intervention Team consultation, structured team meetings, harm-reduction counseling, and coordinated care navigation. Preliminary post-intervention data showed improved addiction treatment engagement (99%), increased discharge on home IV therapy (19% vs. 7%), and reduced need for prolonged inpatient IV therapy. Chart review indicated a 77% clinical cure rate at end of therapy, with manageable rates of adverse events and PICC complications. Continued evaluation will assess financial implications and feasibility in rural settings.