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A recent multi-state investigation has uncovered a concerning trend regarding the treatment of high-risk adults with influenza (flu) in emergency departments and urgent care facilities. The research suggests that more than 50% of these high-risk patients do not receive prompt antiviral treatments. Among those who do get prescriptions, only 80% actually fill them. This delay in treatment poses a significant risk for severe flu-related complications, especially among older populations and those with pre-existing medical conditions.
The study focused on how antiviral medications for influenza are prescribed and dispensed across different demographic segments. Interestingly, the researchers did not find notable disparities based on race, ethnicity, or socio-economic status. Nonetheless, it was observed that adults aged 65 and older, classified as high-risk, were less likely to receive timely prescriptions or have their medications dispensed compared to their younger counterparts.
High-risk patients included individuals with conditions such as cardiovascular disease, chronic kidney disease, weakened immune systems, or those over the age of 70. For these groups, swift antiviral intervention is essential since influenza can trigger severe health complications that extend beyond respiratory issues, including influenza encephalitis, an infection that inflames the brain and can lead to significant health challenges.
Dr. Shaun Grannis, M.D., M.S., the vice president for data and analytics at the Regenstrief Institute and co-author of the study, emphasized, “While effective vaccines against influenza exist, many adults remain unvaccinated. Breakthrough cases still happen, but we have antiviral medications that can help mitigate complications.” He added the urgency of timely treatment for individual and public health safety, urging anyone with respiratory symptoms to reach out to their healthcare provider promptly.
Patients who underwent rapid flu tests in urgent care centers or emergency departments were more frequently prescribed and dispensed antivirals. These quick tests provide results within 5 to 10 minutes, enabling healthcare providers to confirm influenza diagnoses and begin antiviral treatment within the critical 48-hour window.
Antiviral drugs are designed to combat flu viruses in a manner akin to how antibiotics treat bacterial infections. However, their effectiveness deteriorates significantly if treatment is initiated more than 48 hours after the onset of symptoms. Many patients seek care beyond this timeframe, resulting in reluctance from providers to prescribe antivirals. Concerns about potential drug interactions are also prevalent, especially for high-risk patients who may be on multiple medications.
This research utilized electronic health record (EHR) data from 94 urgent care clinics and 142 emergency departments across five states: California, Minnesota, Oregon, Washington, and Wisconsin, as part of the Centers for Disease Control and Prevention (CDC) VISION Network.
Investigators from the Regenstrief Institute have been leaders in the field of clinical decision support. Based on their findings, Dr. Grannis advocates for the integration of decision support tools within electronic health records. “By incorporating clinical decision support systems, we can assist providers in ensuring that high-risk patients receive antiviral treatments when they are most effective,” he stated.
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