Antiviral Chemoprophylaxis Use during Influenza Outbreaks in Long-term Care FacilitiestextSilva, JoecreatorZullo, AndrewAdvisorGravenstein, StefanReaderBrown University. Department of Epidemiologysponsor2020vii, 17 p.born digitalThesis (Sc. M.)--Brown University, 2020thesesAbstract of Antiviral Chemoprophylaxis Use during Influenza Outbreaks in Long-term Care Facilities, by Joe Silva, ScM, Brown University, May 2020. Objectives: Current guidelines recommend use of antiviral chemoprophylaxis for influenza outbreak management in long-term care facilities (LTCFs), which may also develop their own policies. Little is known about these policies, their alignment with national evidence-based guidelines, or whether LTCFs adhere to either local policies or national guidelines during influenza outbreaks. We evaluated LTCF adherence to local chemoprophylaxis policies and national guidelines. Design: We conducted a concurrent cohort study of LTCFs during the 2017-18 and 2018-19 influenza seasons using secondary surveillance data from the Rhode Island Department of Health (RIDOH) supplemented with primary data. Setting and Participants: We included all LTCF outbreaks reported to the RIDOH influenza surveillance system for respiratory outbreaks in congregate living settings. Methods: We evaluated outbreaks through interviews with LTCF staff responsible for influenza surveillance during which chemoprophylaxis policies were documented. LTCF adherence to facility policies and national guidelines was assessed for each outbreak. Descriptive statistics were used to evaluate adherence. Results: Of 74 influenza outbreaks, 50 (68%) involved chemoprophylaxis use that did not adhere to national guidelines. Outbreaks occurred in 53 unique LTCFs, of which 52 were interviewed. Thirty-seven percent (n=19) of LTCFs reported no written policy on chemoprophylaxis and 44% (n=23) reported a policy that did not coincide with national guidelines due to an unmatched specified duration of antiviral chemoprophylaxis. For outbreaks that occurred in LTCFs that reported evaluable policies (n=42), 50% (n=21) were non-adherent to the LTCF-established policy. Conclusions and Implications: Use of antiviral chemoprophylaxis often deviated from both national guidelines and local LTCF policies. Adoption of antiviral chemoprophylaxis policies by LTCFs and harmonization of existing policies to national guidelines could reduce non-adherence to guideline-recommended best practices.Nursing homesInfluenzaCommunicable diseasesAntiviral agentsInfection--ControlEnglishRPB20200720In CopyrightCollection is open for research.