A recent multi-state study has uncovered significant gaps in the treatment of influenza among high-risk adults, particularly those who are diagnosed in emergency departments and urgent care settings. According to research findings published in Clinical Infectious Diseases, a disconcertingly low percentage of these patients receive timely antiviral treatment.

Study Overview

The study highlighted that only slightly more than half of high-risk adults diagnosed with influenza were prescribed antiviral medications, and of those prescriptions, only 80% were filled. This under-treatment is particularly concerning for older adults and individuals with pre-existing conditions, as untreated influenza can lead to severe complications, such as:

  • Influenza encephalitis: A serious brain infection resulting in inflammation.
  • Pneumonia: A potential outcome that can endanger patients with weakened immune systems.
  • Exacerbation of chronic diseases: Conditions such as asthma or chronic obstructive pulmonary disease (COPD) can worsen.

Demographic Insights

The research analyzed electronic health records from 94 urgent care facilities and 142 emergency departments across five states—California, Minnesota, Oregon, Washington, and Wisconsin—facilitated by the Centers for Disease Control and Prevention (CDC) VISION Network. Strikingly, while the study identified overall gaps in treatment, no significant disparities based on race, ethnicity, or socioeconomic vulnerability were found. However, older adults aged 65 and over were less likely to receive timely prescriptions or to have their prescriptions dispensed when compared to younger high-risk adults.

Factor Impact on Treatment
Age Older adults less likely to receive timely antiviral prescriptions.
Health Status Patients with chronic conditions experience increased risks of complications.
Rapid Testing Increased likelihood of timely antiviral prescriptions.

The Importance of Timely Antiviral Treatment

Timely intervention with antiviral medications is crucial, as these drugs aim to inhibit the replication of influenza viruses in the body, similar to how antibiotics function against bacterial infections. However, the effectiveness of these antivirals diminishes significantly if treatment begins more than 48 hours after symptom onset. Providers frequently hesitate to prescribe antivirals due to the timing of patient visits, especially since many patients seek care after this critical window has passed.

"Although effective influenza vaccines are available, many adults remain unvaccinated, and breakthrough cases still occur. Fortunately, we have antivirals that can reduce complications." – Shaun Grannis, M.D., M.S., Vice President for Data and Analytics, Regenstrief Institute.

Barriers to Effective Treatment

Despite the known benefits of antiviral medications, several barriers to proper treatment persist:

  • Lack of awareness: Many patients, particularly older adults, may not recognize the seriousness of their symptoms.
  • Logistical issues: Delays in testing and prescription processes can hinder access to timely treatment.
  • Concerns over drug interactions: High-risk patients with multiple prescriptions are often subjected to polypharmacy, raising concerns about potential adverse effects.

Recommendations and Future Directions

Based on the study's findings, Dr. Grannis suggests that implementing clinical decision support tools could help mitigate barriers to timely antiviral treatment. By integrating these tools into health care systems, providers can be guided to prescribe necessary antiviral treatments for high-risk patients effectively.

Policy Implications

Improving public health outcomes regarding influenza requires a multifaceted approach that includes:

  • **Enhanced outreach programs** to promote influenza vaccinations among adults.
  • **Strategic use of rapid testing** to facilitate timely diagnoses and treatment.
  • **Education for health care providers** about the importance of swift antiviral prescribing.

Ultimately, addressing these gaps in flu treatment for high-risk adults is vital to reducing morbidity and mortality associated with influenza.

References

Katherine Adams et al, Patterns in prescribing and dispensing of influenza antivirals among adults with influenza presenting to urgent care and emergency department settings, VISION Network, 2023–2024, Clinical Infectious Diseases (2025). Source.