1. Physician characteristics associated with antiviral prescriptions for older adults with COVID-19 in Japan: an observational study.
- Author
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Miyawaki, Atsushi, Kitajima, Kei, Iwata, Akihiro, Sato, Daichi, and Tsugawa, Yusuke
- Subjects
COVID-19 ,Drug Utilization ,Electronic Health Records ,Health Services Accessibility ,INFECTIOUS DISEASES ,Physicians ,Male ,Humans ,Female ,Aged ,COVID-19 ,Japan ,Cross-Sectional Studies ,Ritonavir ,Antiviral Agents ,Hydroxylamines ,Cytidine ,Nitriles ,Lactams ,Proline ,Leucine - Abstract
OBJECTIVES: Although guidelines recommend antiviral therapy for outpatients with COVID-19 who are at high risk of progressing to severe conditions, such as older adults, many patients do not receive appropriate treatment. Little is known, however, about the physician factors associated with the prescription of guideline-recommended antiviral therapy for patients with COVID-19. DESIGN: A cross-sectional study. SETTING: Data including outpatient visits in primary care clinics in Japan from April to August 2023. PARTICIPANTS: We analysed 30 953 outpatients aged ≥65 years treated with COVID-19 (mean (SD) age, 75.0 (7.6) years; 17 652 women (57.0%)) in 1394 primary care clinics. OUTCOME MEASURES: The primary outcome was the prescription of guideline-recommended antivirals (ie, nirmatrelvir-ritonavir or molnupiravir), adjusted for patient characteristics, months of visits and regions. RESULTS: Antiviral prescriptions were concentrated among a small proportion of physicians; for example, the top 10% of physicians that had the largest number of nirmatrelvir-ritonavir prescriptions accounted for 92.4% of all nirmatrelvir-ritonavir prescriptions. After adjusting for potential confounders, physicians with higher patient volumes were more likely to prescribe guideline-recommended antivirals to their patients (adjusted OR (aOR) for high vs low volume, 1.76; 95% CI 1.31 to 2.38; adjusted p
- Published
- 2024