Baxter Healthcare, the University Hospitals Coventry and Warwickshire (UHCW) NHS Trust, and Environmental Resources Management (ERM) have jointly published the results of a report showing the significant environmental benefits of OPAT, when compared with the traditional inpatient model of intravenous (IV) antimicrobial therapy.
OPAT is a clinically effective and cost-effective method of delivering antimicrobial therapy outside the hospital for appropriate patients who are otherwise medically fit. The peer-reviewed report, published in the JAC-Antimicrobial Resistance, shows antimicrobial therapy self-administered intravenously in the patient’s home greatly reduces CO2 emissions by 85%, compared to in-hospital administration of IV antibiotics.
According to the study, this reduction in CO2 is the same amount (5461 kg CO2 eq per patient population) that is generated from driving a petrol-fuelled passenger car from London to Rome and back six times.
The study assessed the environmental impact of three OPAT care pathways (self-administered OPAT in the home, nurse-assisted OPAT in the home, and nurse-assisted OPAT in an outpatient department) and inpatient administration of IV antibiotics with adult patients (>18 years of age) in the NHS in England for which OPAT was a viable treatment option. The unit of analysis was 10 adult patients, based on the available capacity for patients on the regional NHS (publicly funded) OPAT service offered at any one time by a leading service provider.
The results of the study also show a substantial reduction in both water usage (78%) and waste generated (91%) during self-administered OPAT treatment in the home. Nurse administered OPAT, either in the home or outpatient department, also results in lower use of water, generation of waste and CO2 emissions compared to the inpatient pathway. The analysis identifies the most substantial contributions to the environmental impact of the antimicrobial therapy care pathway are the resources associated with delivering in-patient care.
“We have a direct responsibility in the healthcare industry to explore ways to reduce our climate footprint wherever possible,” said Ann Cole, Senior Government Affairs Manager for Baxter in the United Kingdom and an author of the published report. “With the growing shift towards home-based care and associated patient independence, cost and resource benefits already established, we conducted this investigation to better understand the environmental impact of the outpatient IV antibiotic care pathway. We were delighted to confirm that being treated at home is better for the environment.”
Baxter has been working in direct partnership with the NHS to help patients who are well enough to receive their antibiotic treatment at home through OPAT.
“As the first study of its kind, we hope these results will allow more OPAT services to grow or be developed, play a part in antimicrobial stewardship and thus create a reduction in antimicrobial resistance, and improve the lives of more patients due to quicker discharges back to their own surroundings,” said Dr. Steven Montgomery-Laird, consultant physician in medical microbiology at UHCW and an author of the report.
To treat as many patients as possible and minimise nursing resources required to deliver OPAT, where possible, patients are given training and support to be able to manage their therapy in their home or alternatively a caregiver or family member are trained to support.
View the full paper, titled: 'The environmental impact of intravenous antimicrobial therapies: a comparison of OPAT and inpatient administration care pathways', at: https://pubmed.ncbi.nlm.nih.gov/40070892/
