title: Influenza diagnosis and treatment in veterans with spinal cord injury.
abstract: OBJECTIVE
  To assess influenza diagnosis and treatment behaviors and prescribing practices for antiviral medications among spinal cord injury (SCI) practitioners.
  
  
  METHODS
  Anonymous cross-sectional survey of practitioners and retrospective review of administrative diagnostic and prescription databases.
  
  
  METHODS
  Department of Veterans Affairs health care facilities.
  
  
  METHODS
  One hundred practitioners participated (response rate, 65%).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Strategies for diagnosing and treating influenza and type of antivirals prescribed.
  
  
  RESULTS
  Ninety-seven percent of practitioners reported using clinical symptoms to diagnose a patient with influenza. The most common treatments included symptom relievers (94%), followed by antivirals (21%). Antivirals reportedly used included amantadine (64%), rimantadine (36%), oseltamivir (32%), and zanamivir (11%). Twenty-one prescriptions for antivirals were identified during the influenza season and all were for amantadine.
  
  
  CONCLUSIONS
  Despite recommendations by the U.S. Centers for Disease Control and Prevention and high risks of respiratory complications after SCI, antiviral medications and diagnostic tests for influenza are seldom used in the treatment of influenza in this population. Research is needed to identify barriers to diagnosing and administering antivirals in people with SCI.
authors.affiliation: Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative, Midwest Center for Health Services and Policy Research, Edward Hines Jr VA Hospital, Hines, IL 60141, USA. Charlesnika.Evans@va.gov
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Sherri L
authors.initials: SL
authors.lastname: Lavela
authors.forename: Bridget
authors.initials: B
authors.lastname: Smith
authors.forename: Scott
authors.initials: S
authors.lastname: Miskevics
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D014728:Veterans
chemical_list: D000998:Antiviral Agents