Using published information and computer models, the researchers compared the outcomes and costs of a variety of strategies for caring for older adults with flu-like illness, including no testing or treatment, testing for flu before treatment with a newer or an older anti-flu drug, and treating without testing.
For patients older than 65 who had not been vaccinated or who were at high risk for complications, using a newer anti-flu drug without first testing for flu was cost-effective. For vaccinated or low-risk patients, rapid testing followed by the newer drug if the test is positive appeared to be the best strategy.
Newer anti-flu drugs cost significantly more than older antiviral therapy but combat both influenza A and influenza B. The older, less expensive anti-flu drugs, which combat only influenza A, are a reasonable alternative if patients cannot afford the higher-cost drugs.
Lead study author Michael B. Rothberg, MD, MPH, an internist at Baystate Medical Center in Springfield, Mass., said the results show that, despite their costs, anti-flu drugs are a reasonable strategy for treating older patients with flu symptoms, "But the best advice for older adults is to get a flu shot every year because vaccination decreases the probability of getting the flu and reduces the severity of illness." According to Dr. Rothberg, vaccination decreases the need for hospitalization by one-third and reduces mortality by half.
Influenza occurs in yearly epidemics and can have serious consequences for older adults, especial
Contact: Susan Anderson
American College of Physicians