title: Community IntraVenous Antibiotic Study (CIVAS): protocol for an evaluation of patient preferences for and cost-effectiveness of community intravenous antibiotic services.
abstract: BACKGROUND
  Outpatient parenteral antimicrobial therapy (OPAT) is used to treat a wide range of infections, and is common practice in countries such as the USA and Australia. In the UK, national guidelines (standards of care) for OPAT services have been developed to act as a benchmark for clinical monitoring and quality. However, the availability of OPAT services in the UK is still patchy and until quite recently was available only in specialist centres. Over time, National Health Service (NHS) Trusts have developed OPAT services in response to local needs, which has resulted in different service configurations and models of care. However, there has been no robust examination comparing the cost-effectiveness of each service type, or any systematic examination of patient preferences for services on which to base any business case decision.
  
  
  METHODS
  The study will use a mixed methods approach, to evaluate patient preferences for and the cost-effectiveness of OPAT service models. The study includes seven NHS Trusts located in four counties. There are five inter-related work packages: a systematic review of the published research on the safety, efficacy and cost-effectiveness of intravenous antibiotic delivery services; a qualitative study to explore existing OPAT services and perceived barriers to future development; an economic model to estimate the comparative value of four different community intravenous antibiotic services; a discrete choice experiment to assess patient preferences for services, and an expert panel to agree which service models may constitute the optimal service model(s) of community intravenous antibiotics delivery.
  
  
  BACKGROUND
  The study has been approved by the NRES Committee, South West-Frenchay using the Proportionate Review Service (ref 13/SW/0060). The results of the study will be disseminated at national and international conferences, and in international journals.
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: C
authors: C
authors: Czoski Murray
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: M
authors: M
authors: Twiddy
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: D
authors: D
authors: Meads
authors: Institute for Transport Studies, University of Leeds, Leeds, UK.
authors: S
authors: S
authors: Hess
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: J
authors: http://orcid.org/0000-0002-5239-0173
authors: J
authors: Wright
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: E D
authors: ED
authors: Mitchell
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: C
authors: C
authors: Hulme
authors: Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: S
authors: S
authors: Dodd
authors: Service user.
authors: H
authors: H
authors: Gent
authors: Leeds Community Healthcare Trust, Leeds, UK.
authors: A
authors: A
authors: Gregson
authors: Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors: K
authors: K
authors: McLintock
authors: School of Healthcare, University of Leeds, Leeds, UK.
authors: D K
authors: DK
authors: Raynor
authors: Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: K
authors: K
authors: Reynard
authors: Bradford Teaching Hospitals NHS Foundation Trust, Leeds, UK.
authors: P
authors: P
authors: Stanley
authors: Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: R
authors: R
authors: Vincent
authors: Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: J
authors: J
authors: Minton
mesh_terms: D061605:Administration, Intravenous; D000553:Ambulatory Care / Q000191:economics; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001315:Australia; D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D006699:Home Care Services / Q000191:economics; D006701:Home Nursing / Q000191:economics; D006801:Humans; D018803:Models, Economic; D057240:Patient Preference; D036301:Qualitative Research; D012646:Self Administration / Q000191:economics; D000078202:Systematic Reviews as Topic; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents
keywords: HEALTH ECONOMICS; INFECTIOUS DISEASES; QUALITATIVE RESEARCH