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Research Letter| Volume 21, ISSUE 9, P1354-1356, September 2020

Antiviral Chemoprophylaxis Use During Influenza Outbreaks in Rhode Island Long-Term Care Facilities

  • Joe B. Silva
    Affiliations
    Department of Epidemiology, Brown University School of Public Health, Providence, RI
    Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
    Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
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  • Elliott Bosco
    Affiliations
    Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
    Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
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  • Daniela N. Quilliam
    Affiliations
    Center for Acute Infectious Disease Epidemiology, Rhode Island Department of Health, Providence, RI
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  • Stefan Gravenstein
    Affiliations
    Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
    Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
    Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI
    Department of Medicine, Alpert Medical School, Brown University, Providence, RI
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  • Andrew R. Zullo
    Affiliations
    Department of Epidemiology, Brown University School of Public Health, Providence, RI
    Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
    Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
    Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI
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Published:July 11, 2020DOI:https://doi.org/10.1016/j.jamda.2020.05.020
Antiviral Chemoprophylaxis Use During Influenza Outbreaks in Rhode Island Long-Term Care Facilities
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      The population of older adults who live in long-term care facilities (LTCFs) is at a particularly high risk for influenza exposure and associated harms.
      • Dickinson D.T.
      • He J.
      • Gussin G.
      • et al.
      Quantifying influenza exposure within California hospitals and nursing homes using administrative data.
      Am J Infect Control. 2020; 48: 831-833
      When influenza is detected within an LTCF, the Centers for Disease Control and Prevention recommends that antiviral chemoprophylaxis be initiated as soon as possible for all residents on affected wings and continued for a duration of 14 days or until at least 7 days after the last resident's onset of illness.
      Interim guidance for influenza outbreak management in long-term care and post-acute care facilities.
      https://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm
      Date accessed: November 5, 2019
      ,
      • Uyeki T.M.
      • Bernstein H.H.
      • Bradley J.S.
      • et al.
      Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza A.
      Clin Infect Dis. 2019; 68: e1-e47
      To what degree LTCFs adhere to this national guideline during outbreaks is unknown. As part of facility-specific outbreak control protocols, LTCF staff may also develop their own antiviral chemoprophylaxis policies. Few data describe the existence of these policies or their alignment with national guidelines. Without this information, it is difficult to develop interventions to improve the use of antiviral chemoprophylaxis in response to influenza outbreaks to mitigate harm in this vulnerable population. To address this gap, we examined LTCF staff adherence to national guidelines, variation in self-established chemoprophylaxis policies, and LTCF staff adherence to these policies during influenza outbreaks.
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      References

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        • He J.
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        • et al.
        Quantifying influenza exposure within California hospitals and nursing homes using administrative data.
        Am J Infect Control. 2020; 48: 831-833
        View in Article
      2. Interim guidance for influenza outbreak management in long-term care and post-acute care facilities.
        (Available at:)
        https://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm
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      Article info

      Publication history

      Published online: July 11, 2020

      Footnotes

      Funding Sources: This work was supported by the Rhode Island Department of Health’s Center for Acute Infectious Disease Epidemiology. A.R.Z. is supported by awards R21AG061632 from the National Institute on Aging, U54GM115677 from the National Institute of General Medical Sciences, and a US Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Health Services Research and Development.

      E.B., S.G., and A.R.Z. are all supported, in part, by a grant from Sanofi Pasteur to Brown University for a project examining the epidemiology of infections and vaccine use in long-term care facilities. A.R.Z. is a United States Government employee and D.N.Q. is a Rhode Island State Government employee. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the Rhode Island Department of Health, the state of Rhode Island, or the United States Government. All other authors declare no conflicts of interest.

      Identification

      DOI: https://doi.org/10.1016/j.jamda.2020.05.020

      Copyright

      © 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

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