Giuseppe
Emeritus
Stockpiling Drugs for an Avian Influenza Outbreak: Examining the Surge in Oseltamivir Prescriptions During Heightened Media Coverage of the Potential for a Worldwide Pandemic - Chicago Journals
Original Article
Stockpiling Drugs for an Avian Influenza Outbreak: Examining the Surge in Oseltamivir Prescriptions During Heightened Media Coverage of the Potential for a Worldwide Pandemic
Leanne B. Gasink, MD, MSCE; Darren R. Linkin, MD, MSCE; Neil O. Fishman, MD; Warren B. Bilker, PhD; Mark G. Weiner, MD; Ebbing Lautenbach, MD, MPH, MSCE
From the Divisions of Infectious Diseases (L.B.G., D.R.L., N.O.F., E.L.) and General Internal Medicine (M.G.W.) of the Department of Medicine, the Department of Biostatistics and Epidemiology (D.R.L., W.B.B., E.L.), the Center for Clinical Epidemiology and Biostatistics (L.B.G., D.R.L., E.L.), and the Center for Education and Research on Therapeutics (L.B.G., D.R.L., N.O.F., E.L.), University of Pennsylvania School of Medicine, Philadelphia.
Objective.
During fall 2005, personal stockpiling of oseltamivir for use during an outbreak of H5N1 influenza virus infection was widely reported. The present study aimed to identify indications for oseltamivir prescriptions to determine whether oseltamivir that was not intended for seasonal influenza was inappropriately consumed and to compare persons who were likely to have stockpiled oseltamivir and those who did not with respect to their knowledge, understanding, concerns, and expectations regarding avian influenza.
Design.
Survey to evaluate usage patterns for oseltamivir and assess views about avian influenza.
Subjects.
A total of 109 outpatients who received a prescription for oseltamivir between September 1, 2005, and December 31, 2005, and 825 matched control subjects.
Results.
Of 109 prescriptions, 36 (33.0%) were prescribed for patients with appropriate indications. Sixty‐eight (62.4%) of 109 patients identified as having received oseltamivir and 440 (53.3%) of 825 individuals identified as not having received it responded to the questionnaire. Only 2 prescription recipients whose oseltamivir was not intended for immediate consumption reported that they had consumed the oseltamivir. Persons who probably intended to stockpile oseltamivir were older and more often white than those unlikely to stockpile it. They also reported greater worry about avian influenza and more often expected avian influenza to spread to the United States than those unlikely to stockpile, but there were no significant differences in responses to other questionnaire items.
Conclusions.
A large proportion of the oseltamivir prescriptions written in fall 2005 were probably intended for personal stockpiling. Similarities in participants' responses to questionnaire items suggest that educational campaigns may not be an effective method to curtail stockpiling of antimicrobial medications during an infectious threat. Promoting appropriate prescribing practices among providers may be a better means by which to minimize personal stockpiling.
Received July 9, 2008; accepted November 24, 2008; electronically published February 23, 2009.
Address reprint requests to Leanne B. Gasink, MD, MSCE, University of Pennsylvania, Ground Floor Penn Tower, Ste. 101, 33rd and Civic Center Boulevards, Philadelphia, PA 19104 (leanne.gasink@uphs.upenn.edu).
* Presented in part: 17th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; Baltimore, Maryland; April 14‐17, 2007.
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<cite cite="http://www.journals.uchicago.edu/doi/abs/10.1086/596609">Chicago Journals - Infection Control and Hospital Epidemiology</cite>Stockpiling Drugs for an Avian Influenza Outbreak: Examining the Surge in Oseltamivir Prescriptions During Heightened Media Coverage of the Potential for a Worldwide Pandemic
Leanne B. Gasink, MD, MSCE; Darren R. Linkin, MD, MSCE; Neil O. Fishman, MD; Warren B. Bilker, PhD; Mark G. Weiner, MD; Ebbing Lautenbach, MD, MPH, MSCE
From the Divisions of Infectious Diseases (L.B.G., D.R.L., N.O.F., E.L.) and General Internal Medicine (M.G.W.) of the Department of Medicine, the Department of Biostatistics and Epidemiology (D.R.L., W.B.B., E.L.), the Center for Clinical Epidemiology and Biostatistics (L.B.G., D.R.L., E.L.), and the Center for Education and Research on Therapeutics (L.B.G., D.R.L., N.O.F., E.L.), University of Pennsylvania School of Medicine, Philadelphia.
Objective.
During fall 2005, personal stockpiling of oseltamivir for use during an outbreak of H5N1 influenza virus infection was widely reported. The present study aimed to identify indications for oseltamivir prescriptions to determine whether oseltamivir that was not intended for seasonal influenza was inappropriately consumed and to compare persons who were likely to have stockpiled oseltamivir and those who did not with respect to their knowledge, understanding, concerns, and expectations regarding avian influenza.
Design.
Survey to evaluate usage patterns for oseltamivir and assess views about avian influenza.
Subjects.
A total of 109 outpatients who received a prescription for oseltamivir between September 1, 2005, and December 31, 2005, and 825 matched control subjects.
Results.
Of 109 prescriptions, 36 (33.0%) were prescribed for patients with appropriate indications. Sixty‐eight (62.4%) of 109 patients identified as having received oseltamivir and 440 (53.3%) of 825 individuals identified as not having received it responded to the questionnaire. Only 2 prescription recipients whose oseltamivir was not intended for immediate consumption reported that they had consumed the oseltamivir. Persons who probably intended to stockpile oseltamivir were older and more often white than those unlikely to stockpile it. They also reported greater worry about avian influenza and more often expected avian influenza to spread to the United States than those unlikely to stockpile, but there were no significant differences in responses to other questionnaire items.
Conclusions.
A large proportion of the oseltamivir prescriptions written in fall 2005 were probably intended for personal stockpiling. Similarities in participants' responses to questionnaire items suggest that educational campaigns may not be an effective method to curtail stockpiling of antimicrobial medications during an infectious threat. Promoting appropriate prescribing practices among providers may be a better means by which to minimize personal stockpiling.
Received July 9, 2008; accepted November 24, 2008; electronically published February 23, 2009.
Address reprint requests to Leanne B. Gasink, MD, MSCE, University of Pennsylvania, Ground Floor Penn Tower, Ste. 101, 33rd and Civic Center Boulevards, Philadelphia, PA 19104 (leanne.gasink@uphs.upenn.edu).
* Presented in part: 17th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; Baltimore, Maryland; April 14‐17, 2007.
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