A Survey of Provider-Reported Use and Perceived Effectiveness of Medications for Symptom Management in Telemedicine and Outpatient Visits for Mild COVID-19

• Type of Material: Article
• Authors: James O'Keefe, Emory University; Lydia C Newsom, Mercer University College of Pharmacy; Thomas H Taylor, Mercer University College of Pharmacy
• Language: English
• Date: 2021-03-22
• Publisher: SPRINGER LONDON LTD
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s40121-021-00432-8
• Title of Journal or Parent Work: INFECTIOUS DISEASES AND THERAPY
• Volume: 10
• Issue: 2
• Start Page: 839
• End Page: 851
• Grant/Funding Information: James O’Keefe is funded by the Georgia Geriatrics Workforce Enhancement Program (GA-GWEP) COVID-19 Telehealth award, supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of Award Number T1MHP39056 totaling $90,625 with 0% percentage financed with non­governmental sources. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. The journal’s Rapid Service Fee was funded by the Paul W. Seavey Internal Medicine Clinic research fund. The funder/sponsor had no direct role in study planning and conduct, reporting, or authorship.
• Keywords: Telemedicine; Survey; Symptom; Outpatient; SARS-CoV-2; Science & Technology; Medication; Infectious Diseases; COVID-19; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Pharmacy

Abstract

Introduction: Many patients with mild coronavirus disease 2019 (COVID-19) have symptoms requiring acute and follow-up care. The aims of this study were to assess (1) provider-reported use of medications and their perceived effectiveness and (2) degree of difficulty managing specific symptoms at episodic COVID-19 care sites and in a longitudinal monitoring program. Methods: We sent an online survey to physicians, advanced practice providers, and registered nurses redeployed to COVID-19 care sites at an academic medical center from March to May 2020. We asked about the use of medications and perceived effectiveness of medications to treat symptoms of COVID-19 and the perceived challenge of symptom management. Comparison was made by provider type (episodic or longitudinal site of care). Results: Responses from 64 providers were included. The most frequently used medications were acetaminophen (87.1% of respondents), benzonatate (83.9%), and albuterol metered dose inhalers (MDI) (80.6%). Therapies for lower respiratory tract symptoms were reported as more commonly used by longitudinal follow-up providers compared to episodic providers including guaifenesin (90.6% vs 60.0%, p = 0.007), benzonatate (93.8% vs 73.3%, p = 0.04), nebulized albuterol for patients with asthma (75.0% vs 43.3%, p = 0.019), and albuterol MDIs for patients without asthma (90.6% vs 66.7%, p = 0.029). Medications found to have the highest perceived efficacy by respondents using the therapy (> 80% reporting “very efficacious”) included albuterol, acetaminophen for fever, non-sedating antihistamines, nasal steroid spray, and non-steroidal anti-inflammatory drugs (NSAIDs) for myalgia, arthralgia, or headache. Lower respiratory symptoms and anxiety were rated as the most challenging symptoms to manage. Conclusions: Providers reported that clinical care of mild COVID-19 with medications in common use for other respiratory infections is effective, both at episodic care and longitudinal sites of care, but that specific symptoms are still challenging to manage.