Impact of Zanamivir Treatment on Productivity, Health Status and Healthcare Resource Use in Patients with Influenza
- 45 Downloads
Objective: This study examined the impact of zanamivir treatment on patient morbidity in patients with influenza.
Design and setting: This was a multicentre, randomised, double-blind, parallel-group study conducted in 14 countries in Europe and North America during the winter of 1995/1996.
Patients and participants: The study included 722 individuals with virologically confirmed influenza.
Interventions: Two different zanamivir treatment regimens [twice daily (bid) or 4 times daily (qid) for 5 days] were compared with placebo.
Main outcome measures and results: Efficacy was measured using a number of patient-assessment questionnaires. Results showed that significantly fewer patients with influenza who were treated with zanamivir had additional contacts with healthcare professionals compared with those who received placebo (8 vs 14%; p ≤ 0.049, bid and qid vs placebo). Individuals treated with zanamivir also spent fewer days absent from work (placebo: mean = 3.28 days; qid: mean = 2.52 days; p = 0.031) or college/school (placebo: mean = 2.90 days; bid: mean = 2.24 days; p = 0.032), and showed significant improvements in productivity compared with placebo. The health status questionnaire revealed significant improvements in patient well-being over the first 5 days of the study in those treated with zanamivir compared with those who received placebo.
Conclusions: Zanamivir treatment reduced absenteeism, improved patient productivity and well-being, and reduced the additional use of healthcare resources in patients with influenza.
KeywordsChronic Obstructive Pulmonary Disease Influenza Sleep Quality Zanamivir Influenza Infection
This research was supported by a grant from Glaxo Wellcome Research and Development.
We would like to thank the following people: Drs G. Adam, E. Barbaix, L. De Lille, V. Formato, M. Pollet and H. van Pottelbergh (Belgium); Drs F. Aoki, G. Boivin, E. Brankston, B. Clecner, J. Dylewski, K. Forward, P. Orr, C. St-Pierre, J. Simonsen, R. Ward, K. Williams and D. Zoutman (Canada); Drs T. Hviid, A. Jorgensen, N. Mosbaek, H. Ohlenschlaeger, M. Makela and T. Rostila (Denmark); Drs M. Behar, R. Benady, M. Chelly, J. Cozic, F. Dupont, P. Huin, J. Luciani, C. Rebelle, A. Serrero, A. Simmons, P. Triot and R. Yaeche (France); Drs H. Becker, D. Berger, P. Klinger, H. Kuhl, D. Schmikale, A. Schwall and S. Tomingas (Germany); Professor P. Crovari, Dr F. Pregliasco and Professor P. Urbano (Italy); Dr R. de Groot (The Netherlands); Drs P. Christensen, H. Gjessing, H. Hauge, K. Innvik, K. Lund, O. Sand and H. Skjerven (Norway); Drs M. Alonso, A. Dalfo, L. De Marcos and M. Palomo (Spain); Drs C. Ahlm, M. Glimaker, Associate Professor B. Ljungberg, Dr K. Pauksens and Associate Professor T. Sandberg (Sweden); Drs J. Adelglass, R. Andruczk, S. Becker, T. Bock, G. Bottenfield, R. Hardoin, H. Resnick, A. Brown, D. Bukstein, S. Campbell, F. Cole, G. Collins, M. Conway, P. Craven, B. deBoisblanc, R. Desai, V. Elinoff, R. Emerson, J. Felicetta, L. Gilderman, D. Gold, A. Graff, J. Grossman, F. Hayden, D. Henry, W. Henry, R. Holloway, S. Kelsen, T. Klein, R. Kobayashi, P. Krumpe, C. Macy, A. Mangione, E. Meltzer, D. Mikolich, A. Monto, C. Briefer, A. Morrison, J. Morton, J. O’Rourke, S. Pace, B. Pogue, P. Ratner, J. Rhudy, E. Riffer, P. Ripley, J. Rubino, G. Ruoff, J. Ryder-Benz, J. Schoenberger, H. Serfer, G. Settipane, D. Skoner, J. Stapleton, W. Stein, J. Stone, J. Tan, C. Van Hook, V. Wender, J. Wheeler and M. Yocum (USA); and Drs M. Duffy, D. Fleming, P. Horn, D. Khan, K. Nicholson, O. O’Toole (England); Dr J. Hosie (Scotland); and Dr H. Thomas (Wales).
- 1.US Centers for Disease Control. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1998; 47 (no. RR-6)Google Scholar
- 4.Office of Technology Assessment, US Congress. Cost effectiveness of influenza vaccination. Washington, DC: Government Printing Office, 1981. Report No.: 052–003-00855–6Google Scholar
- 6.Woods JM, Bethell RC, Coates JAV, et al. 4-guanidino 2, 4-dideoxy-2, 3-dehydro-N-acetylneuraminic acid is a highly effective inhibitor both of the sialidase (neuraminidase) and of growth of a wide range of influenza A and B viruses in vitro. Antimicrob Agents Chemother 1993; 37: 1473–9PubMedCrossRefGoogle Scholar
- 10.Ware JE, Nelson EC, Sherbourne CD, et al. Preliminary tests of a 6-item general health survey: a patient application. In: Stewart AL, Ware JE, editors. Measuring functioning and wellbeing: the Medical Outcomes Study approach. Durham (NC): Duke University Press, 1992Google Scholar
- 11.Ware JE, Kosinski M, Dewey JE, et al. How to score and interpret single-item health status measures: a manual for users of the SF6 and SF8 health surveys. Lincoln (RI): Quality Metric Incoroporated, 1999Google Scholar
- 12.Hays RD, Stewart AL. Sleep measures. In: Stewart AL, Ware JE, editors. Measuring functioning and well-being: the Medical Outcomes Study approach. Durham (NC): Duke University Press, 1992: 235–59Google Scholar
- 14.Fleming D, Makela M, Pauksens K, et al. ’High risk’ and otherwise healthy patients demonstrate alleviation of influenza symptoms 2.5 days earlier following inhaled zanamivir treatment; European study;Winter 1997/8 [abstract no.789]. 36th meeting of the Infectious Diseases Society of America: 1998 Nov 12–15; Denver (CO), 249Google Scholar
- 15.Lalezari J, Klein T, Stapleton J, et al. The efficacy and safety of inhaled zanamivir of influenza in otherwise healthy and ’high risk’ individuals in North America [abstract no. P8]. In: Abstracts of the 21st International Congress of Chemotherapy; 1999 Jul; Birmingham. JAC 1999; 44 Suppl. A: 42Google Scholar
- 16.Silagy CA, Griffin AD, Lacey LA, et al., on behalf of MIST. Impact of zanamivir on health status, productivity and health care resource use in patients with influenza [abstract]. Clin Infect Dis 1998; 27 (4): 926Google Scholar