Association of physician experience with a higher prescription rate of anti-influenza agents in low-risk patients
| Autor: | Yukio Tsugihashi, Hiroyasu Ishimaru, Ryuichi Sada, Hiroyuki Akebo, Koji Nakajima |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Decision Making 030204 cardiovascular system & hematology Logistic regression Antiviral Agents Anti-influenza Agents 03 medical and health sciences 0302 clinical medicine Japan Physicians Influenza Human Internal Medicine Medicine Humans 030212 general & internal medicine Medical prescription education education.field_of_study business.industry Medical record Emergency department Guideline Middle Aged Patient Acceptance of Health Care Logistic Models Prescriptions Emergency medicine Emergency Medicine Female Educational interventions business |
| Zdroj: | Internal and emergency medicine. 16(5) |
| ISSN: | 1970-9366 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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