Underuse of SARS-CoV-2-Neutralizing Monoclonal Antibodies in Skilled Nursing Facilities.
Catharine I Paules, Nicole Osevala, Erik Lehman and 5 others
PMID 37944905WHAT IT FOUND
Monoclonal antibodies were severely underused in skilled nursing facilities, with over half of the 130 facilities administering zero doses despite residents being high-risk.
Micropolitan facilities had higher odds of use, likely due to better hospital support, while staffing shortages hindered delivery.
Key findings
01Over half of the facilities administered zero monoclonal antibody doses, with a mean usage rate of 12.96% per case.
02Facilities in micropolitan areas had significantly higher odds of administering monoclonal antibodies compared to those in metropolitan areas.
03Most monoclonal antibodies were stored off-site, indicating reliance on external support systems for administration.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study could not determine if residents who did not receive mabs were actually eligible based on clinical guidelines at the time. It did not account for residents who received mabs through other providers or alternative treatments like paxlovid. The data was limited to Pennsylvania and Ohio, so results may not apply to other regions. The study could not assess the impact of race, ethnicity, or Medicare status on mab access. Staffing shortage data was self-reported and may not capture the full nuance of resource availability.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government funding sources, but specific sponsor involvement in design or writing was not detailed in the provided text.
The easy way to misread this
Do not interpret the low usage rates as evidence that monoclonal antibodies were ineffective or that clinicians refused to use them. The study highlights systemic logistical and staffing barriers, not clinical rejection of the therapy.