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Who gets treated for influenza: A surveillance study from the US Food and Drug Administration’s Sentinel System

Published online by Cambridge University Press:  05 August 2021

Noelle M. Cocoros Open the ORCID record for Noelle M. Cocoros [Opens in a new window] ,
Nicole Haug ,
Austin Cosgrove ,
Catherine A. Panozzo ,
Alfred Sorbello ,
Henry Francis ,
Crystal Garcia ,
Robert Orr ,
Sengwee Toh  and
Sarah K. Dutcher
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Noelle M. Cocoros*
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Nicole Haug
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Austin Cosgrove
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Catherine A. Panozzo
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Alfred Sorbello
Affiliation:
US Food and Drug Administration, Silver Spring, Maryland
Henry Francis
Affiliation:
US Food and Drug Administration, Silver Spring, Maryland
Crystal Garcia
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Robert Orr
Affiliation:
US Food and Drug Administration, Silver Spring, Maryland
Sengwee Toh
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Sarah K. Dutcher
Affiliation:
US Food and Drug Administration, Silver Spring, Maryland
Gregory T. Measer
Affiliation:
US Food and Drug Administration, Silver Spring, Maryland
*
Author for correspondence: Noelle M. Cocoros, E-mail: noelle_cocoros@harvardpilgrim.org
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Abstract

Objective:

We describe the baseline characteristics and complications of individuals with influenza in the US FDA’s Sentinel System by antiviral treatment timing.

Design:

Retrospective cohort design.

Patients:

Individuals aged ≥6 months with outpatient diagnoses of influenza in June 2014–July 2017, 3 influenza seasons.

Methods:

We identified the comorbidities, vaccination history, influenza testing, and outpatient antiviral dispensings of individuals with influenza using administrative claims data from 13 data partners including the Centers for Medicare and Medicaid Services, integrated delivery systems, and commercial health plans. We assessed complications within 30 days: hospitalization, oxygen use, mechanical ventilation, critical care, ECMO, and death.

Results:

There were 1,090,333 influenza diagnoses in 2014–2015; 1,005,240 in 2016–2017; and 578,548 in 2017–2018. Between 49% and 55% of patients were dispensed outpatient treatment within 5 days. In all periods >80% of treated individuals received treatment on the day of diagnosis. Those treated on days 1–5 after diagnosis had higher prevalences of diabetes, chronic obstructive pulmonary disease, asthma, and obesity compared to those treated on the day of diagnosis or not treated at all. They also had higher rates of hospitalization, oxygen use, and critical care. In 2014–2015, among those aged ≥65 years, the rates of hospitalization were 45 per 1,000 diagnoses among those treated on day 0; 74 per 1,000 among those treated on days 1–5; and 50 per 1,000 among those who were untreated.

Conclusions:

In a large, national analysis, approximately half of people diagnosed with influenza in the outpatient setting were treated with antiviral medications. Delays in outpatient dispensed treatment were associated with higher prevalence of comorbidities and higher rates of complication.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 9 , September 2022 , pp. 1228 - 1234
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Behrman, RE, Benner, JS, Brown, JS, McClellan, M, Woodcock, J, Platt, R. Developing the Sentinel System—a national resource for evidence development. N Engl J Med 2011;364:498–499.CrossRefGoogle ScholarPubMed
Robb, MA, Racoosin, JA, Sherman, RE, et al. The US Food And Drug Administration’s sentinel initiative: expanding the horizons of medical product safety. Pharmacoepidemiol Drug Saf 2012;21 suppl 1:9–11.CrossRefGoogle Scholar
Ball, R, Robb, M, Anderson, SA, Dal Pan, G. The FDA’s sentinel initiative—A comprehensive approach to medical product surveillance. Clin Pharmacol Ther 2016;99:265–268.CrossRefGoogle ScholarPubMed
Platt, R, Brown, JS, Robb, M, et al. The FDA Sentinel Initiative—an evolving national resource. N Engl J Med 2018;379:2091–2093.CrossRefGoogle Scholar
Rosati, K, Jorgensen, N, Plc, CB. Sentinel Initiative principles and policies: HIPAA and Common Rule Compliance. Sentinel Initiative website. https://www.sentinelinitiative.org/sites/default/files/communications/publications-presentations/HIPAA-Common-Rule-Compliance-in-Sentinel-Initiative.pdf. Accessed July 15, 2021.Google Scholar
Electronic Code of Federal Regulations (eCFR). Electronic Code of Federal Regulations (eCFR) website. https://www.ecfr.gov/. Accessed January 26, 2021.Google Scholar
Measer, GT, Maher, CT, Hu-Primmer, J. Monitoring and assessment of medical countermeasures as part of a public health emergency response. Am J Public Health 2018;108:S224–S226.CrossRefGoogle ScholarPubMed
HCA COVID-19 activities: monitoring critical drugs and assessment of natural history of disease. Sentinel Initiative website. https://www.sentinelinitiative.org/methods-data-tools/methods/hca-covid-19-activities-monitoring-critical-drugs-and-assessment-natural. Published 2020. Accessed February 28, 2021.Google Scholar
Biggerstaff, M, Jhung, MA, Reed, C, Fry, AM, Balluz, L, Finelli, L. Influenza-like illness, the time to seek healthcare, and influenza antiviral receipt during the 2010-2011 influenza season—United States. J Infect Dis 2014;210:535–544.CrossRefGoogle ScholarPubMed
Fowlkes, AL, Steffens, A, Reed, C, Temte, JL, Campbell, AP. Influenza Incidence Surveillance Project Working Group. Influenza antiviral prescribing practices and the influence of rapid testing among primary care providers in the US, 2009–2016. Open Forum Infect Dis 2019;6:ofz192.CrossRefGoogle Scholar
Stewart, RJ, Flannery, B, Chung, JR, et al. influenza antiviral prescribing for outpatients with an acute respiratory illness and at high risk for influenza-associated complications during 5 influenza seasons—United States, 2011–2016. Clin Infect Dis 2018;66:1035–1041.CrossRefGoogle ScholarPubMed
Cocoros, NM, Panucci, G, Haug, N, Maher, C, Reichman, M, Toh, S. Outpatient influenza antivirals in a distributed data network for influenza surveillance. Influenza Respir Viruses 2018;12:804–807.CrossRefGoogle Scholar
Appiah, GD, Blanton, L, D’Mello, T, et al. Influenza activity—United States, 2014–15 season and composition of the 2015-16 influenza vaccine. Morb Mortal Wkly Rep 2015;64:583–590.Google ScholarPubMed
Davlin, SL, Blanton, L, Kniss, K, et al. Influenza activity—United States, 2015–16 season and composition of the 2016–17 influenza vaccine. Morb Mortal Wkly Rep 2016;65:567–575.CrossRefGoogle ScholarPubMed
Blanton, L, Mustaquim, D, Alabi, N, et al. Update: Influenza activity—United States, October 2, 2016–February 4, 2017. Morb Mortal Wkly Rep 2017;66:159–166.CrossRefGoogle ScholarPubMed
Eick-Cost, AA, Hunt, DJ. Assessment of ICD-9–based case definitions for influenza-like illness surveillance. MSMR 2015;22:2–7.Google ScholarPubMed
Enger, C, Nordstrom, BL, Thakrar, B, Sacks, S, Rothman, KJ. Health outcomes among patients receiving oseltamivir. Pharmacoepidemiol Drug Saf 2004;13:227–237.CrossRefGoogle ScholarPubMed
Data brief 402: emergency department visits for influenza and pneumonia: United States, 2016–2018. National Center for Health Statistics website. https://stacks.cdc.gov/view/cdc/102795. Published March 2021, Accessed June 4, 2021.Google Scholar
Miller, MR, Peters, TR, Suerken, CK, Snively, BM, Poehling, KA. Predictors of influenza diagnosis among patients with laboratory-confirmed influenza. J Infect Dis 2015;212:1604–1612.CrossRefGoogle ScholarPubMed
Chow, EJ, Rolfes, MA, O’Halloran, A, et al. Respiratory and nonrespiratory diagnoses associated with influenza in hospitalized adults. JAMA Netw Open 2020;3:e201323.CrossRefGoogle ScholarPubMed
Lloyd, JT, Blackwell, SA, Wei, Howell BL, Shrank WH. Validity of a claims-based diagnosis of obesity among medicare beneficiaries. Eval Health Prof 2015;38:508–517.CrossRefGoogle ScholarPubMed
Overman, RA, Freburger, JK, Assimon, MM, Li, X, Brookhart, MA. Observation stays in administrative claims databases: underestimation of hospitalized cases. Pharmacoepidemiol Drug Saf 2014;23:902–910.CrossRefGoogle ScholarPubMed
Haynes, K. Mortality: the final outcome. Pharmacoepidemiol Drug Saf 2019;28:570–571.CrossRefGoogle ScholarPubMed
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