Association of physician experience with a higher prescription rate of anti-influenza agents in low-risk patients.
Adolescent
Adult
Antiviral Agents
/ administration & dosage
Decision Making
Female
Humans
Influenza, Human
/ drug therapy
Japan
/ epidemiology
Logistic Models
Male
Middle Aged
Patient Acceptance of Health Care
/ statistics & numerical data
Physicians
/ psychology
Prescriptions
/ statistics & numerical data
Antiviral agents
Influenza
Influenza testing
Medical records
Prescriptions
Rapid influenza diagnostic testing
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
22
08
2020
accepted:
10
11
2020
pubmed:
4
1
2021
medline:
3
11
2021
entrez:
3
1
2021
Statut:
ppublish
Résumé
During the influenza season, most patients suspected of having influenza undergo rapid influenza diagnostic tests (RIDTs) in Japan despite their low sensitivity. However, the physician's actual rationale for prescribing antivirals, besides the results of RIDTs, remains poorly understood. Our study sought to identify the role of clinical information and physicians' experience in the initiation of anti-influenza agents. We retrospectively reviewed 380 patients who underwent RIDTs at the emergency department of our hospital from September 2018 to May 2019. Data regarding sex, age, etc., which could affect the decision of prescribing antivirals, were extracted from medical records. We performed logistic regression analysis to analyze the concurrent effect of potentially relevant clinical factors, results of RIDTs, and the physician's status on antiviral prescription. Multivariable analysis revealed that a positive RIDT had the largest effect on antiviral prescription, followed by physician status, high regional influenza activity, and patients' presentation within 12 h of symptom onset. Patient's age, comorbidities, and presentation after 48 h of symptom onset were not associated with antiviral treatment. Physicians with more years of experience were significantly more likely to prescribe antivirals for patients with low risk of complications. Our findings revealed the physicians' rationale for initiating antiviral treatment and the discrepancy with guideline indications of antivirals, which is the patient's age and comorbidities. Physicians, especially those with more than 3 years of experience, frequently prescribed antivirals for patients with low risk of complications; thus, educational interventions against this population could be useful to improve this situation.
Identifiants
pubmed: 33389450
doi: 10.1007/s11739-020-02570-2
pii: 10.1007/s11739-020-02570-2
doi:
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1215-1221Informations de copyright
© 2021. Società Italiana di Medicina Interna (SIMI).
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