Improving patient outcomes - a 3 month review of the pharmacist-led COpAT service at University Hospitals of Derby and Burton

Sep 29, 2026

The Complex Outpatient Antimicrobial Therapy (COpAT) service supports safe delivery of high-risk oral antimicrobial regimens in the community to optimize clinical outcomes and reduce adverse effects. Pharmacists are increasingly central to monitoring within the COpAT pathway, identifying and managing adverse drug reactions (ADRs), potential toxicities, drug interactions, abnormal blood results, and adherence. A retrospective 3-month review at University Hospitals of Derby and Burton evaluated patient outcomes, ADR management, and pharmacist-led intervention scope.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Background

Objectives

Methods

Results

Conclusions

Posters Abstract citation ID: dlaf239.016 P12 Improving patient outcomes: a 3 month review of the pharmacist-led COpAT service at University Hospitals of Derby and Burton Anne Boadi1, Chris Durojaiye1, Charlotte Fiori1 1University Hospitals of Derby and Burton NHS Foundation Trust, Derbyshire, UK Posters Background: The Complex Outpatient Antimicrobial Therapy (COpAT) service facilitates the safe delivery of high-risk oral antimicrobial regimens in the community, aiming to optimize clinical outcomes and reduce adverse effects. The deﬁnition of‘complex’ in this context is patient-speciﬁc may relate to the antimicrobial regimen, the patient’s clinical proﬁle or infection characteristics. Pharmacists play an increasingly integral role in patient monitoring within the COpAT pathway, identifying and managing adverse drug reactions (ADRs) and potential toxicities. Objectives: To evaluate the clinical impact and effectiveness of the pharmacist-led COpAT service at University Hospitals of Derby and Burton (UHDB) over a 3 month period, focusing on patient outcomes, ADR management, and the nature and scope of pharmacist-led interventions. Methods: A retrospective review was conducted of all patients referred and enrolled in the COpAT pathway at UHDB between May and July 2025 . Specialist COpAT pharmacists assessed suitability for enrolment and monitored for ADRs, drug interactions, abnormal blood results, and adherence. Pharmacists also liaised with multidisciplinary teams (MDTs) as required. Data collection involved a retrospective analysis of pharmacist documentation to identify and categorize clinical issues ﬂagged during monitoring. Results: Twenty-eight patients (age 36–89 years; 19 male, 9 female) were monitored. Infections included osteomyelitis (n=17), spinal infections (n=3), prosthetic joint infections (n=2), diabetic foot infections without osteomyelitis (n=2), septic arthritis (n= 1), bacteraemia (n= 1), urinary tract infection (n=1) and intra-abdominal abscess (n=1) . Thirteen patients received oral linezolid and ﬁfteen received oral cotrimoxazole, with several receiving additional agents such as sodium fusidate, ciproﬂoxacin or metronidazole. Outcomes showed 13 patients (46%) completed therapy without complications, 4 (14%) completed therapy with ADRs, 3 (11%) completed therapy following a treatment change, 6 (21%) failed therapy due to deterioration or intolerance and 2 (7%) had unknown outcomes due to non-compliance. ADRs were agent speciﬁc. Among patients receiving linezolid, nausea was most reported (23%), with additional reports of headache (n=2), dizziness (n=1), metallic taste (n=1), sleep disturbance (n=1), cracked sore mouth (n= 1), and bruising (n= 1) . In the co-trimoxazole group, hyperkalaemia affected 20% of patients, with other ADRs including thrombocytopenia (n=2), acute kidney injury (n=1), neutropenia (n=1), and leukopenia (n= 1) . Pharmacists made multiple clinical interventions. Three instances involved additional counselling beyond the initial antibiotic review, supporting ADR management and adherence. Antiemetics were prescribed three times to manage linezolid-associated nausea. Pharmacists escalated abnormal blood results on eight occasions, including thrombocytopenia, hyperkalaemia, leukopenia, acute kidney injury, and low haemoglobin. Four interventions involved coordinating antibiotic regimen changes with MDTs, and in ﬁve cases pharmacists liaised with parent teams to escalate clinical deterioration or address complex decisions. Conclusions: This evaluation highlights the valuable contribution of pharmacists in delivering a safe, effective and patient centred COpAT service. Through proactive monitoring, pharmacists play a pivotal role in managing adverse effects, ensuring adherence, and optimizing clinical outcomes, while also driving antimicrobial stewardship. Embedding pharmacists formally within this pathway enhances stewardship efforts and reduces inpatient burden. Beyond cl

FAQs

What is the COpAT service and what is its purpose in the community?

COpAT delivers high-risk oral antimicrobial regimens safely outside inpatient care. It aims to optimize clinical outcomes and reduce adverse effects.

How was the pharmacist-led COpAT service evaluated over the 3-month period?

A retrospective review analyzed all patients referred and enrolled between May and July 2025. COpAT pharmacists assessed suitability, monitored for ADRs and interactions, reviewed blood results and adherence, and documented clinical issues for categorization.

What outcomes and pharmacist interventions were reported?

Twenty-eight patients were monitored, with 46% completing therapy without complications and 14% completing therapy with ADRs. Pharmacists conducted counselling, prescribed antiemetics for linezolid nausea, escalated abnormal blood results, and coordinated regimen changes with multidisciplinary teams.

Sep 29, 2026

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