Influenza antiviral treatment in spinal cord injury patients, 2007-2010 Journal Article

Authors: Evans, C. T.; Rogers, T. J.; Goldstein, B; Weaver, F M; LaVela, S. L.
Article Title: Influenza antiviral treatment in spinal cord injury patients, 2007-2010
Abstract: Objective This study assessed antiviral medication use for treatment of influenza-like illness (ILI) in Veterans with spinal cord injury or disorder (SCI/D) and examined whether antiviral prescribing improved over time. Design Retrospective cohort study of Department of Veteran Affairs (VA) facilities. Participants Veterans with SCI/D and matched non-SCI/D controls (matched by facility and date of visit/admission) who were diagnosed by a clinician with ILI during the period 1 October 2007 to 31 May 2010. Main outcome measures Antiviral receipt and appropriateness were examined. Appropriate antiviral prescribing was defined as patients who received an antiviral medication within 2 days of collection of a sample for diagnostic testing or within 2 days of symptom onset. Results We identified 101 influenza visits/admissions for Veterans with SCI/D and 123 for controls. Antiviral prescribing for Veterans with SCI/D increased from 37.1% in 2007/2008 to 67.6% in 2009/2010 (P = 0.01) and appropriate antiviral prescribing increased from 20.0 to 41.2% (P = 0.05). Predictors of antiviral prescribing included being treated in the 2009/2010 influenza season (vs. 2007/2008) and having a cough. Fever, aches/myalgia, or a positive influenza test was associated with appropriate antiviral treatment. SCI/D was an independent predictor of receiving antiviral treatment (adjusted odds ratio = 1.16, 95% confidence interval 1.04-1.29), but having SCI/D was not associated with receiving appropriate treatment. Conclusions Influenza antiviral prescribing increased over time and in a larger proportion in Veterans with SCI/D (vs. controls). This suggests that providers treating patients with SCI/D recognize treatment guidelines and their importance in a high-risk population. Continued efforts are needed to improve appropriate influenza antiviral prescribing.
Journal Title: The journal of spinal cord medicine
ISSN: 1079-0268; 1079-0268
Publisher: Unknown  
Date Published: 2014
Language: ENG
Notes: JID: 9504452; OTO: NOTNLM; aheadofprint