Differences in COVID-19 Outpatient Antiviral Treatment Among Adults Aged ≥65 Years by Age Group - National Patient-Centered Clinical Research Network, United States, April 2022-September 2023.

Adults aged ≥65 years experience the highest risk for COVID-19-related hospitalization and death, with risk increasing with increasing age; outpatient antiviral treatment reduces the risk for these severe outcomes. Despite the proven benefit of COVID-19 antiviral treatment, information on differences in use among older adults with COVID-19 by age group is limited. Nonhospitalized patients aged ≥65 years with COVID-19 during April 2022-September 2023 were identified from the National Patient-Centered Clinical Research Network. Differences in use of antiviral treatment among patients aged 65-74, 75-89, and ≥90 years were assessed. Multivariable logistic regression was used to estimate the association between age and nonreceipt of antiviral treatment. Among 393,390 persons aged ≥65 years, 45.9% received outpatient COVID-19 antivirals, including 48.4%, 43.5%, and 35.2% among those aged 65-75, 76-89, and ≥90 years, respectively. Patients aged 75-89 and ≥90 years had 1.17 (95% CI = 1.15-1.19) and 1.54 (95% CI = 1.49-1.61) times the adjusted odds of being untreated, respectively, compared with those aged 65-74 years. Among 12,543 patients with severe outcomes, 2,648 (21.1%) had received an outpatient COVID-19 antiviral medication, compared with 177,874 (46.7%) of 380,847 patients without severe outcomes. Antiviral use is underutilized among adults ≥65 years; the oldest adults are least likely to receive treatment. To prevent COVID-19-associated morbidity and mortality, increased use of COVID-19 antiviral medications among older adults is needed.

The hidden patient: The CARE framework to care for caregivers.

Caregivers, or persons who provide unpaid support to a loved one who could not manage to live independently or whose health or well-being would deteriorate without this help, are increasingly common. These rates have only increased with the COVID-19 pandemic forcing many to care for sick family members in the short or long term. Unfortunately, caregiving is associated with significant burden and health risks, not only for caregivers themselves but also for the care recipients of overwhelmed caregivers. These risks have also been exacerbated by the social isolation of the COVID-19 pandemic. Although interventions exist which have been proven to reduce caregiver burden, education on these interventions is lacking, partly because there has not been a memorable framework on how to care for caregivers. In this paper, an innovative framework to teach clinicians about caring for caregivers is introduced, the C.A.R.E. framework: Caregiver well-being, Advanced care planning, Respite, and Education. This simple framework will help providers become aware of caregiver needs, comfortable in addressing their needs, and able to suggest interventions proven to reduce caregiver burden. Knowledge of this framework should start with medical students so that they can incorporate this critical aspect of primary care into their clinical practice early on in their careers. If providers can simply remember to perform these four interventions, to C.A.R.E. for our caregivers, then they will make a significant impact on the lives of both our patients and their loved ones, during the present COVID-19 pandemic and thereafter.