Association of physician experience with higher prescription rate of
anti-influenza agents in low-risk patients.
Rationale, aims, and objectives; 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. Method; 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. Results; 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 hours of
symptom onset. Patient’s age, comorbidities, and presentation after 48
hours 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.
Conclusions; Our findings revealed the physicians’ rationale for
initiating antiviral treatment and the discrepancy with guideline
indications of antivirals, which is 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.