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. 2015 Jan;38(1):48-56.
doi: 10.1179/2045772314Y.0000000237. Epub 2014 Jun 24.

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

Charlesnika T Evans, Thea J Rogers, Barry Goldstein, Frances M Weaver, Sherri L LaVela

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

Charlesnika T Evans et al. J Spinal Cord Med. 2015 Jan.

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 Veterans 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.

Keywords: Antivirals; Appropriate prescribing; Influenza; Spinal cord injury.

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Figure 1
Figure 1
Antiviral prescribing and appropriateness of prescribing in SCI/D and control group over time.
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References

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