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  • Being ‘at-home’ on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents’ experiences of paediatric OPAT

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Original research
Being ‘at-home’ on outpatient parenteral antimicrobial therapy (OPAT): a qualitative study of parents’ experiences of paediatric OPAT
  1. Bernie Carter1,
  2. Debra Fisher-Smith2,
  3. David Porter3,
  4. Steven Lane4,
  5. Matthew Peak5,6,
  6. David Taylor-Robinson7,
  7. Louise Bracken8,
  8. Enitan Carrol9
  1. 1 Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
  2. 2 Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
  3. 3 Department of Infectious Diseases, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  4. 4 Biostatistics, University of Liverpool, Liverpool, UK
  5. 5 Research and Development, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  6. 6 Cheshire and Merseyside Medicines for Children Research Network, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  7. 7 Department of Public Health and Policy, University of Liverpool, Liverpool, UK
  8. 8 Paediatric Medicines Research Unit, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  9. 9 Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
  1. Correspondence to Professor Bernie Carter, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK; bernie.carter{at}edgehill.ac.uk

Abstract

Objective To better understand the factors that facilitate and hinder a positive experience of paediatric outpatient parenteral antimicrobial therapy (OPAT).

Design Qualitative study using semistructured interviews.

Setting A dedicated paediatric consultant-led hospital-based, outreach OPAT service in England.

Participants Participants were primarily parents of children who had received OPAT; one child participated.

Methods Children and parents of children who received OPAT and who had participated in the survey phase of the larger study were invited to be interviewed.

Results 12 parents (10 mothers and 2 fathers) of 10 children participated; one child (aged 15 years). Data analysis resulted in one meta-theme, ‘At-homeness’ with OPAT, this reflected the overall sense of home being a place in which the children and their parents could be where they wanted to be. Four key themes were identified that reflect the ways in which parents and children experienced being at-home on OPAT: ‘Comfort, security, freedom, and control’; ‘Faith, trust and confidence’; ‘Explanations and communication’ and ‘Concerns, restrictions and inconveniences’.

Conclusions Despite feeling anxious at times, parents reported that they and their children generally had a positive experience of OPAT; being at-home brought many benefits compared with in-patient care. Recommendations arising from the study include a ‘whole-system’ approach to discharge home that includes support related to return to school/nursery, reduction in disruptions to home-based routines, more clarity on choice and preparation for managing potential anxiety, better consideration of dose timing and enhanced preparation and information.

  • antimicrobial therapy
  • children
  • community
  • OPAT
  • at-home
  • support
  • information
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/archdischild-2019-317629

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    Footnotes

    • Contributors EDC, BC DT-R, DP, SL, LB and MP designed the study and applied for funding. DP and DF-S recruited patients and collected data. BC wrote the first draft of the manuscript. All authors contributed to drafting the manuscript.

    • Funding This work was supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast (NIHR CLAHRC NWC): study reference CLAHRC-NWC-034. The views expressed are those of the authors and not necessarily those of the NHS, NIHR or Department of Health and Social Care.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval Ethics approval was gained (NW Greater Manchester West Research Ethics Committee 16/NW/0440).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.