TOPLINE:
The use of an infusion-attached remote therapeutic monitoring device with an integrated care platform was significantly associated with reduced hospital readmissions and emergency room (ER) visits through 90 days and high adherence among outpatients receiving parenteral antimicrobial therapy.
METHODOLOGY:
- Researchers conducted a prospective study at two US hospitals to evaluate the impact of a remote therapeutic monitoring program on unplanned healthcare utilization in outpatients receiving parenteral antimicrobial therapy, to measure adherence rates, and to identify predictors of adherence.
- They enrolled 212 patients (median age, 59 years; 55.2% male) discharged home on parenteral antimicrobials: 81 who used the remote monitoring device comprised the intervention group, and 131 who declined comprised the control group.
- The primary outcome was any all‑cause healthcare utilization — specifically hospital readmission or an ER visit — assessed 30, 60, and 90 days after discharge. Secondary outcomes included all-cause hospital readmissions and all-cause ER visits assessed separately at the same follow-up timepoints.
- Adherence was defined as receipt of at least 90% of infusions at the scheduled times and frequency. Weekly adherence of less than 90% (doses administered within 1 hour of the scheduled time) was classified as low, and weekly adherence of at least 90% was classified as high.
TAKEAWAY:
- Patients in the intervention group had a significant reduction in all-cause healthcare utilization — 39% at 60 days (adjusted hazard ratio [aHR], 0.61; P = .030) and 38% at 90 days (aHR, 0.62; P = .027) — compared with those in the control group. A similar trend toward reduced healthcare utilization was observed at 30 days but did not reach statistical significance.
- A trend toward fewer hospital readmissions and ER visits was observed in the intervention group compared with the control group, but the difference was not statistically significant.
- Overall, median adherence in the intervention group was 94%, with 61.7% of patients maintaining high adherence throughout the course of therapy.
- The presence of diabetes (adjusted odds ratio [aOR], 4.81; P = .007) and receipt of penicillin (aOR, 6.99; P = .014) were independent predictors of low adherence to parental antibiotic therapy.
IN PRACTICE:
“We anticipate that RTM [remote therapeutic monitoring] may prove particularly valuable in institutions with smaller or inexistent OPAT [outpatient parenteral antimicrobial therapy] infrastructure,” the authors of the study wrote.
“We also believe that RTM will play a major role in OPAT regimens requiring therapeutic drug monitoring such as vancomycin or aminoglycosides by providing an accurate record of dose timing,” they added.
SOURCE:
The study was led by Emily A. Siegrist, OU Health, Oklahoma City. It was published online on January 8, 2026, in Clinical Infectious Diseases.
LIMITATIONS:
The study was limited by its nonrandomized design and the use of a contemporaneous control group and by the retrospective collection of healthcare utilization data. Additionally, patients in the intervention group received extra contact from the remote therapeutic monitoring team, which may have contributed to higher adherence.
DISCLOSURES:
The study was funded by a grant to the University of Oklahoma from Community Infusion Solutions and IV Ensure, Inc. Four authors reported being employees of IV Ensure, Inc. Some authors reported receiving research grants or consulting fees or serving on speaker bureaus for various companies, including IV Ensure, Ansun Biopharma, and Melinta Therapeutics.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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