Adam L. Hersh, MD, PhD; Randall S. Stafford, MD, PhD
Disclaimer: The statements, findings, conclusions, views, and opinions contained and expressed in this article are based in part on data obtained under license from the National Disease and Therapeutic Index (2006 to 2010), IMS Health. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IMS Health or any of its affiliated or subsidiary entities.
Grant Support: By grant T32HD044331 from the National Institute of Child Health and Human Development (Dr. Hersh) and training grant K24HL086703 from the National Heart, Lung, and Blood Institute (Dr. Stafford).
Potential Conflicts of Interest: Dr. Stafford: Expert testimony: Mylan Pharmaceuticals. Grants/grants pending (money to institution): Toyo-Shinyaku, Procter & Gamble, Partnership for Prevention, Stanford University, American Heart Association, Wako Inc., GlaxoSmithKline. Grants/grants pending: University of Chicago. Honoraria: American Drug Utilization Review Society, American College of Preventive Medicine, Partnership for Prevention. Payment for manuscript preparation: Massachusetts Medical Society. Travel/accommodations/expenses covered or reimbursed: Partnership for Prevention, National Committee for Quality Assurance, American College of Preventive Medicine, American Heart Association, University of Chicago, IMS Health, Drug Information Association, Bayer. Dr. Hersh: Grants received (money to institution): National Institutes of Health. Consultancy: Colorado Guidelines Committee.
Hersh AL, Stafford RS. Antiviral Prescribing by Office-Based Physicians During the 2009 H1N1 Pandemic. Ann Intern Med. 2011;154:74-76. doi: 10.7326/0003-4819-154-1-201101040-00019
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Published: Ann Intern Med. 2011;154(1):74-76.
Background: Adherence to guidelines during public health emergencies is a national priority. Throughout the 2009 H1N1 influenza pandemic (1), the Centers for Disease Control and Prevention (CDC) issued guidelines recommending antiviral prescribing only to selected patients at high risk for complications, including patients younger than 2 years and patients 65 years or older, and not for prophylaxis (2). The extent to which antivirals were prescribed and how these practices differed from those in previous years is unknown.
Methods and Findings: We used data from the National Disease and Therapeutic Index (NDTI), a nationally representative survey of visits to ambulatory physicians produced by IMS Health, Plymouth Meeting, Pennsylvania. The survey includes approximately 4800 sampled physicians each calendar quarter who provide information about every clinical encounter during 2 consecutive workdays. Physicians are selected by random-stratified sampling by specialty and geographic region from the master lists of the American Medical Association and the American Osteopathic Association. Data for each visit include patient diagnoses based on codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), and medications prescribed during these visits. The complex sampling frame allows extrapolation to national estimates for office visits and associated prescriptions. The NDTI has been used to examine patterns of medication prescribing (3, 4), with results that are consistent with the federally conducted National Ambulatory Medical Care Survey (5).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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