• Antiviral therapy · Jan 2015

    Use of neuraminidase inhibitors in primary health care during pandemic and seasonal influenza between 2009 and 2013.

    • Thierry Blanchon, Félicité Geffrier, Clément Turbelin, Isabelle Daviaud, Cédric Laouénan, Xavier Duval, Bruno Lambert, Thomas Hanslik, Anne Mosnier, and Catherine Leport.
    • Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris, France. thierry.blanchon@upmc.fr.
    • Antivir. Ther. (Lond.). 2015 Jan 1; 20 (7): 753-61.

    BackgroundIn a context of controversy about influenza antiviral treatments, this study assessed primary health-care physicians' prescription of neuraminidase inhibitors (NIs) in France during pandemic and seasonal influenza between 2009 and 2013.MethodsThis observational study, using data recorded in three national databases, estimated the rate of NI prescription among influenza-like illness (ILI) patients seen in GP and paediatrician consultations, and determined factors associated with this prescription according to a multivariate analysis. NI delivery by pharmacists was also evaluated.ResultsRates of NI prescription were estimated to be 61.1% among ILI patients with a severe influenza risk factor seen in GP consultation during the A(H1N1)pdm2009 pandemic versus an average rate of 25.9% during the three following seasonal influenza epidemics. Factors associated with NI prescription were a chronic disease in patients under 65 years (OR 14.85; 95% CI 13.00, 16.97) and in those aged 65 and older (OR 7.54; 5.86, 9.70), an age ≥65 years in patients without chronic disease (OR 1.35; 1.04, 1.74), a pregnancy (OR 10.63; 7.67, 15.76), obesity (OR 4.67; 3.50, 6.22) and a consultation during the pandemic A(H1N1)pdm2009 (OR 3.19; 2.93, 3.48). The number of antiviral treatments delivered by pharmacists during the A(H1N1)pdm2009 pandemic was 835 per 100,000 inhabitants, and an average of 275 per 100,000 inhabitants during the three following seasonal influenza epidemics.ConclusionsAlthough physicians seem to follow the recommended indications for NIs in primary health-care practice, this study confirms the low rate of NI prescription to ILI patients with a severe influenza risk factor, especially during seasonal epidemics.

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