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18% of nursing home residents with COVID-19 received antiviral drugs during the pandemic

18% of nursing home residents with COVID-19 received antiviral drugs during the pandemic

 


Disclosure:
McGarry reports receiving grants from the National Institute on Aging and the Agency for Healthcare Research and Quality, and consulting fees from AARP. See this study for relevant financial disclosures of all other authors.


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Important points:

  • Nursing home facilities with large numbers of non-whites and Medicaid residents were less likely to give COVID-19 patients antiviral drugs.
  • More than 40% of nursing homes reported never receiving antiviral medications.

Researchers found that only one in four COVID-19 nursing home residents received antiviral treatment from May 31, 2021 to the end of 2022, despite a higher risk of adverse COVID-19 outcomes.

Brian E. McGarry, PT, PhD, An assistant professor of medicine at the University of Rochester Medical Center and colleagues wrote: JAMA network open Residents of special nursing homes have a high priority for antiviral treatment for new coronavirus infections for the following reasons. High risk of serious infections.

Photo of a common area in a retirement home

More than 40% of nursing homes reported never receiving antiviral medications. Image: Adobe Stock.

“Although use of oral antivirals has been found to be higher in nursing homes than in the community, use among nursing home residents overall is low and may not be commensurate with the increased risk among residents,” the researchers wrote.

They added that there are some barriers to implementing antiviral treatment in nursing homes. Changes to Authorizations and Recommendations for Use of Monoclonal Antibodies, patient and physician preferences, unfamiliarity with these agents, and cost of treatment. ”

Using data from the CDC’s National Healthcare Safety Network Nursing Home COVID-19 database, McGarry and colleagues assessed trends in COVID-19 treatment rates in nursing homes from May 31, 2021 through December 25, 2022.

Across 15,092 nursing homes, 763,340 residents were infected with COVID-19 and 136,066 residents were receiving COVID-19 treatment during the survey period.

The overall antiviral treatment rate over the entire study period was 17.8% (95% CI, 17.4-18.3). The mean rate increased to 24.5% (95% CI, 23.2-25.7) in his last 6 weeks. Moving average treatment rates peaked at 32.7% (95%CI, 30.5-34.8) on 21 November 2021.

The researchers noted that 61.1% of treatments in 2022 consisted of paxlobid (nirmatrelvir-ritonavir, Pfizer) and 18.2% consisted of lagebrio (molnupiravir, Merck).

There was a steady increase in the percentage of nursing homes that had received antiviral drugs for COVID-19. However, McGarry et al. found that 41% reported still not using it by the end of 2022.

Several factors contribute to the increased likelihood of antiviral drug use by institutions, including:

  • Larger bed size.
  • Higher overall quality rating.
  • Affiliated geriatrician.
  • High resident and staff vaccination rates.and
  • Residents have high average age and visual acuity.

In contrast, facilities with a for-profit aspect and high proportions of Medicaid and nonwhite residents were less likely to use antivirals.

This study was limited by an observational design that prevented casual interpretation by researchers. Furthermore, we were unable to determine treatment eligibility at the resident level.

McGarry et al. contributes to underuse Disparities in antiviral treatment of COVID-19 in nursing homes”.

References:

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