Outpatient parenteral antimicrobial therapy (OPAT) is a mechanism for delivery of antimicrobial therapy outside of inpatient care; however, risks associated with OPAT combined with transition-of-care vulnerabilities may result in unscheduled healthcare use. On 6/15/2020, our institution launched a program entailing OPAT plan review and reconciliation by infectious diseases (ID) pharmacists prior to hospital discharge. We analyzed the frequency of all-cause 90-day emergency department (ED) visits, readmissions, and mortality of patients pre- and post-implementation of OPAT plan reconciliation.MethodsUnique, adult OPAT recipients discharged to home or a post-acute care facility from an academic hospital before (6/1/2017-6/14/2020) and after (6/15/2020-6/30/2022) implementation of ID pharmacist review and reconciliation of OPAT plans were included. We performed a propensity score-weighted analysis to compare 90-day outcomes pre- and post-intervention while adjusting for relevant clinical characteristics. We accounted for missing data by using multiple imputation.ResultsA total of 2408 OPAT patients met inclusion criteria: 1650 pre-implementation and 758 post-implementation. Patients in the post-implementation group had statistically fewer ED visits (pre: 22.2%; post: 17.8%; p = 0.02) and hospital readmissions (pre: 38.9%; post: 33.4%; p = 0.01) within 90 days after discharge from index admission when compared to the pre-implementation cohort. There was no significant difference in the 90-day all-cause mortality between cohorts.ConclusionsFollowing implementation of OPAT plan reconciliation by ID pharmacists prior to discharge to home from acute care, OPAT recipients were significantly less likely to experience 90-day ED visits or 90-day readmissions.