Outpatient Antiviral Treatment for COVID-19 and Influenza

Early antiviral treatment can help reduce the duration of symptoms and certain complications in patients with risk factors for severe COVID-19 or influenza illness. Yet uptake remains low, and many patients who meet eligibility criteria for antivirals do not ultimately receive them. Results from this survey will help us understand why eligible patients are not receiving these therapeutics as well as resources that might help increase the uptake of antivirals to eligible patients.

We would like to better understand potential barriers to using antiviral therapeutics for COVID-19 and influenza.

If your practice or experience in the past 6 months has not included management of COVID-19 or influenza - stop here & click submit below Please indicate the likelihood you or providers at your institution would choose to use / prescribe / recommend the following antivirals for eligible outpatients for either COVID-19 or influenza:   Never Occasionally Frequently Almost always Nirmatrelvir/ritonavir (Paxlovid) Remdesivir (Veklury) Molnupiravir (Lagevrio) Oseltamivir (generic or Tamiflu) Baloxavir marboxil (Xofluza) Zanamivir (Relenza) Peramivir (Rapivab) What are the factors that typical providers consider when prescribing antiviral treatment to eligible outpatients at your institution with COVID-19 or influenza?   COVID-19 Influenza Age (e.g. young children, older adults) Prior infection(s) Prior immunization(s) Immunosuppressive condition or medications Other underlying medical conditions Patient request What are the barriers faced by typical providers at your institution when prescribing antiviral treatment to eligible outpatients with COVID-19 or influenza? a. Patient Barriers/Hesitation COVID-19 Influenza   Affordability of treatment   Concerns about side effects (ex. metallic taste) or safety   Doesn’t feel sick   Not at risk for severe disease due to prior infection and/or vaccination   Concerns about rebound after treatment b. Provider Barriers/Hesitation COVID-19 Influenza   Unsure about eligibility criteria   Short treatment window   Do not feel antiviral treatment is effective or no RCT data to support use   Potential adverse effects from treatment   Difficulty assessing drug interactions   Unknown lab results (e.g. renal function)   Immunity from illness or vaccination What resources would help increase the uptake of antivirals to eligible outpatients?   Very helpful Somewhat helpful Not helpful Clinical decision-making tools Outreach and education for immunosuppressed patients Increased low-cost, rapid multiplex testing availability Pharmacist prescribing authorities Prepositioning of antivirals in critical settings (long-term care facilities, etc.) New therapeutics Provider and patient education regarding eligibility, effectiveness, and safety Expanding insurance coverage or access programs Create or expand Test-to-Treat programs If a monoclonal antibody product for pre-exposure prophylaxis of SARS-CoV-2 infection were to be authorized that has effectiveness against current circulating variants, would you / your colleagues offer it to immunocompromised patients? Yes      No Is there anything else you would like to share about you or your colleagues’ experiences (including primary care and other specialties) using COVID-19 or influenza antivirals, reasons for using or not using them for outpatients, and how this has changed over time?

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