When patients in the ED are diagnosed with influenza by means of a rapid test, they get fewer unnecessary antibiotics, are prescribed antiviral medications more frequently and have fewer additional lab tests compared with patients diagnosed with influenza without testing, according to a study.
Published Nov. 13 on the website of the Journal of the Pediatrics Infectious Diseases Society, the findings suggest diagnosing influenza with a rapid diagnostic test leads to more appropriate, specific and efficient care.
In the study, researchers used data from the National Hospital Ambulatory Medical Care Survey, a nationally representative sample of ED visits in the U.S. They identified children and adults across three influenza seasons (2007-09) who were diagnosed with influenza in the ED. They looked at how the patients were diagnosed either with or without the use of a rapid influenza test and the subsequent care they received.
Among patients diagnosed with influenza without rapid testing, 23% of the ED visits included a prescription for antibiotics, which are not effective in treating influenza. However, for patients who were diagnosed by rapid testing, only 11% of ED visits resulted in the patient getting antibiotics.
Additional laboratory tests, including chest X-rays, blood tests and urinalysis, were also ordered less frequently for patients whose influenza illness was diagnosed with a rapid test.
Notably, prescriptions for antiviral drugs, which can be effective in treating influenza when used early and appropriately, were more frequent (56% of ED visits) among patients diagnosed with influenza using a rapid test, compared with antiviral use among influenza patients diagnosed without testing (19% of ED visits).
The study suggests a significant impact from rapid influenza testing on clinician decision-making, patient care and use of healthcare resources, despite the limited sensitivity of currently available rapid tests, which miss a number of true cases of influenza, wrote Anne J. Blaschke, MD, PhD, of the University of Utah School of Medicine, and colleagues. The development of faster and more accurate tests for influenza available at the bedside could further improve care for patients with influenza or other respiratory illness, they noted.
The researchers findings build on previous studies by others, focused primarily on children, that found rapid influenza testing can influence patient care in specific settings. This latest study breaks new ground, Blaschke said, by using nationwide data and by demonstrating that the findings apply to both adults and children, and across different practice types.