Trends in COVID-19-Related Medication Use in US Nursing Homes, 2018-2022.
Yuan Zhang, Kaleen N Hayes, Melissa R Riester and 4 others
PMID 37336494WHAT IT FOUND
Prescribing of COVID-19 drugs in nursing homes tracked regulatory approvals more than clinical guidelines.
Dexamethasone and azithromycin use rose and fell sharply after FDA actions, while remdesivir remained rare until late in the study period despite hospital availability.
Key findings
01Dexamethasone use increased sharply to 121.9 per 1000 residents in late 2020 after the RECOVERY trial announcement.
02Hydroxychloroquine use spiked in early 2020 and dropped rapidly after the FDA revoked its emergency use authorization.
03Remdesivir use remained very low throughout the study, reaching only 0.34 per 1000 residents in early 2022.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data comes from 11 specific nursing home corporations and may not represent all US nursing homes. The study facilities had a lower proportion of for-profit organizations and a higher concentration in the Midwest compared to national averages. Remdesivir use may be underestimated because the drug often requires intravenous administration outside the nursing home, which might not be fully documented in facility records. The study did not analyze medication doses, which could affect effectiveness and safety.
Declared interests
The study was supported by the National Institutes of Health. No other conflicts of interest are declared in the text.
The easy way to misread this
Do not interpret these trends as evidence that the medications were effective or safe for the residents. The study describes what was prescribed, not how patients responded, and notes that prescribing often lagged behind or deviated from clinical guidelines.