Appropriateness of antiviral prescribing for influenza in primary care: a retrospective analysis.
Appropriateness of antiviral prescribing for influenza in primary care: a retrospective analysis.
复制标题
初级保健中流感抗病毒处方的适当性：回顾性分析。
DOI：
10.1111/j.1365-2710.2006.00731.x
复制
发表时间：
2006
影响因子：
2
通讯作者：
Bates,DW
中科院分区：
文献类型：
--
作者：
Linder,JA;Chan,JC;Bates,DW
Background and objective:Antiviral medications cost‐effectively reduce influenza‐related morbidity and potentially mortality. We sought to assess the appropriateness of antiviral prescribing for influenza.Method:We performed a retrospective analysis of visits by adults to primary care clinics during influenza seasons from 1 October 2000 to 31 May 2004 with a claims diagnosis of influenza (n= 535) or with an electronic antiviral prescription (n= 25). We defined appropriate antiviral prescribing as the patient having (a) symptoms for 2 or fewer days, (b) fever and (c) any two of headache, sore throat, cough, or myalgias.Results and discussion:Physicians diagnosed patients with influenza in 102 of 535 (19%) visits with a claims diagnosis of influenza. Physicians prescribed antivirals at 15 of 102 (15%) of these visits. The addition of 25 additional electronic antiviral prescriptions gave a sample of 127 visits and 40 (31%) antiviral prescriptions. Twenty‐eight (70%) antiviral prescriptions were appropriate. Among patients who did not receive antivirals, 21 of 87 (24%) met criteria for appropriate antiviral prescribing. Antiviral prescribing was associated with a shorter median symptom duration (2 days vs. 3 days;P< 0·01) and higher median temperature (37·8 °C vs. 36·9 °C;P< 0·01). Physicians prescribed antivirals more frequently to patients who had myalgias (37% vs. 18%;P= 0·04) and an influenza test (67% vs. 28%;P< 0·01). Physicians prescribed antivirals more frequently to Blacks (44%) and patients with other race/ethnicity (67%) than to Whites (20%) or Hispanics (20%;P< 0·0001).Conclusions:To improve antiviral prescribing for influenza in primary care, interventions need to target the accurate identification of influenza visits, undertreatment, as well as inappropriate treatment.
