Influenza Antiviral Use Among High-Risk Outpatients During Four Recent Influenza Seasons—United States, 2011–2015

Abstract

Background. Influenza is a contagious respiratory illness that results in 115,000- 630,000 hospitalizations in the US annually. Early antiviral treatment can reduce the risk of complications, including hospitalization and death, and is recommended by CDC for all outpatients at increased risk of influenza-associated complications due to age or comorbidities. However, previous studies suggest that antiviral prescribing is low. We examined four recent influenza seasons to assess the frequency of influenza antiviral prescriptions among high-risk outpatients and to determine which characteristics predict receipt of an antiviral medication. Methods. We analyzed antiviral prescription data for outpatients aged >=6 months who presented with respiratory illness of =65 years, 8% with >=1 underlying medical condition, and 16% of pregnant women. Among 3794 high-risk outpatients who presented early, 593 (16%) were prescribed antivirals. Of those, 1083 had PCR-confirmed influenza infection and 399 (37%) were prescribed antiviral treatment. Early presentation to care was significantly associatedwith receipt of an antiviral prescription (OR = 8.26, CI: 6.4-10.7), as was testing positive for influenza (OR = 4.79, CI: 4.1-5.6) and the presence of an underlying medical condition (OR = 1.32, CI: 1.1-1.7) among other factors. Conclusion. In this multi-state study, influenza antiviral medications were consistently under-prescribed for high-risk outpatients. Further efforts are needed to better understand barriers to antiviral prescribing and to improve use in order to reduce influenza- associated complications. (Table Presented).