Use of neuraminidase inhibitors in primary health care during pandemic and seasonal influenza between 2009 and 2013: Outpatient influenza antiviral treatmentReport as inadecuate




Use of neuraminidase inhibitors in primary health care during pandemic and seasonal influenza between 2009 and 2013: Outpatient influenza antiviral treatment - Download this document for free, or read online. Document in PDF available to download.

* Corresponding author 1 iPLESP - Institut Pierre Louis d-Epidémiologie et de Santé Publique 2 GROG - Réseau des Groupes Régionaux d-Observation de la Grippe 3 IAME - Infection, Antimicrobiens, Modélisation, Evolution 4 Unité de Biostatistiques 5 CIC Hôpital Bichat 6 Service d-Etudes de Marché 7 Service de Médecine Interne 8 UFR des sciences de la santé Simone Veil 9 Unité de Coordination des Risques Epidémiques et Biologiques

Abstract : BACKGROUND:In a context of controversy about influenza antiviral treatments, this study assessed primary health-care physicians- prescription of neuraminidase inhibitors NIs in France during pandemic and seasonal influenza between 2009 and 2013.METHODS:This observational study, using data recorded in three national databases, estimated the rate of NI prescription among influenza-like illness ILI patients seen in GP and paediatrician consultations, and determined factors associated with this prescription according to a multivariate analysis. NI delivery by pharmacists was also evaluated.RESULTS:Rates of NI prescription were estimated to be 61.1% among ILI patients with a severe influenza risk factor seen in GP consultation during the AH1N1pdm2009 pandemic versus an average rate of 25.9% during the three following seasonal influenza epidemics. Factors associated with NI prescription were a chronic disease in patients under 65 years OR 14.85; 95% CI 13.00, 16.97 and in those aged 65 and older OR 7.54; 5.86, 9.70, an age ≥65 years in patients without chronic disease OR 1.35; 1.04, 1.74, a pregnancy OR 10.63; 7.67, 15.76, obesity OR 4.67; 3.50, 6.22 and a consultation during the pandemic AH1N1pdm2009 OR 3.19; 2.93, 3.48. The number of antiviral treatments delivered by pharmacists during the AH1N1pdm2009 pandemic was 835 per 100,000 inhabitants, and an average of 275 per 100,000 inhabitants during the three following seasonal influenza epidemics.CONCLUSIONS:Although physicians seem to follow the recommended indications for NIs in primary health-care practice, this study confirms the low rate of NI prescription to ILI patients with a severe influenza risk factor, especially during seasonal epidemics.

Keywords : treatment outcome Influenza neuraminidase inhibitors epidemiologic factors primary healthcare





Author: Thierry Blanchon - Félicité Geffrier - Clément Turbelin - Isabelle Daviaud - Cédric Laouénan - Xavier Duval - Bruno Lambert

Source: https://hal.archives-ouvertes.fr/



DOWNLOAD PDF




Related documents