Researchers at the University of Rochester and Harvard University analyzed data reported to Medicare from nursing homes under special pandemic regulations. The study showed that only about 25 percent of COVID-19 residents were prescribed antiviral medications from May 2021 to December 2022. This study was funded by the National Institutes of Health and the National Institute on Aging. published Online Friday by JAMA.
Nursing homes may have been better able to provide treatment to patients, especially after paxlovid tablets became widely available from the second quarter of 2022, the study says. Previously available monoclonal antibody therapies required blood transfusions into the bloodstream, making them more difficult to administer. Another FDA-approved antiviral tablet for treating Covid-19 is Merck’s Lajevrio, but it’s not as effective as Paxlovid.
“Massive underuse of paxlovid, especially in nursing homes, will almost certainly result in avoidable mortality,” said Michael Burnett, a clinician and professor of health care and policy at the Harvard School of Public Health. It has led to an increase,” he said.
Upon FDA approval in December 2021, pivotal clinical trials show that paxlovid reduces the risk of death and hospitalization by 88 percent in people with the greatest risk factors, including older adults and those with underlying medical conditions. found.A more recent study that analyzed results from the VA database found that Pax Lovid reduction The risk of death increases by 47% and the risk of hospitalization increases by 24%.
Researchers involved in analyzing the new nursing homes said in interviews that some clinicians may not have been familiar with antiviral treatment during the study period. Patients may also have been discouraged by reports that a coronavirus “rebound” could occur even after the pills had initially suppressed the infection. President Biden was the most high-profile patient suffering a rebound. However, the drug has been found to be very protective for older people.
Nursing home industry trade groups said facilities are facing difficulties in both supplying and prescribing doctors. “Staff at nursing homes are committed to working with doctors, pharmacists and families to use all available tools, including treatment, to protect residents from the serious consequences of COVID-19.” said David Gifford, chief medical officer of the American Medical Association. National Living Support Center.
“However, nursing homes faced significant challenges in obtaining these drugs and persuading doctors to prescribe them. It means prioritizing those in vulnerable positions and providing clear guidance to healthcare workers, especially during a pandemic.”
FDA approves paxlovid for people at high risk of severe Covid-19 symptoms: Elderly, obese, diabetic and other people with serious medical conditions. 3 tablets he should take twice a day for 5 days.of process Must be started within 5 days after symptoms appear. It has some drawbacks. The tablets are large and leave a metallic taste in the mouth. Another common side effect is diarrhea. It also interacts adversely with some other medications, including blood thinners commonly prescribed for older people.
But the researchers said it was worth suspending blood thinners for a few days while taking paxlobid to reduce the risk of death and hospitalization from COVID-19. “Almost all nursing home residents are over the age of 50 and have multiple chronic conditions. This is the population that is considered to be the target of the
Facilities with affiliated geriatricians were better able to administer antiviral drugs to infected residents than nursing homes without geriatricians, suggesting there may be knowledge gaps in some facilities. ing. Non-profit organizations also performed better than for-profit organizations. Medicaid residents and nonwhite residents also received drugs at lower rates.
Studies have shown that 40% of all nursing homes reported not having a single resident receiving antiviral medications. “There is a lot of weight on the shoulders of clinicians who are not consistently adhering to guidelines, and there is also a gap in access to quality healthcare providers with up-to-date clinicians,” McGarry said. rice field.
