RSV infection is a leading cause of medical care in older adults, sometimes leading to hospital admission and severe outcomes. Although the majority of RSV infections are managed outside hospitals, little is known on the burden of RSV in older adults in the primary care setting. Accurate estimates of the RSV burden in primary care is particularly relevant since vaccines against RSV infection in older adults will likely become available for the general population soon. The use of high-quality point-of-care (POC) molecular viral diagnostics allows to identify RSV infected older adults and would therefore contribute to fill one of the most important gaps in knowledge facilitating implementation of RSV vaccination of older adults With this prospective, observational study, we aim to define the disease burden of RSV infection in older adults in the primary care setting.
Th RAPID study is a prospective, observational study in Dutch primary care practices during two RSV seasons. As part of routine care, rapid molecular viral diagnostic testing on respiratory samples will be offered to all older adults attending the primary care physician because of symptoms of acute respiratory tract infection (ARTI). RSV positive cases will be included for further study. Participants will be asked to fill out three questionnaires by phone or by online at day 0, 14 and 30 after the GP-visit. The main endpoint is the burden of medically attended RSV infection in the Dutch primary care setting, quantified using several clinical and socioeconomic parameters, including (but not limited to) clinical symptoms and their duration, medicine use, hospitalisation rate, quality of life and ability to perform normal daily activities. Secondary, data on health care consumption and indirect costs will be collected and we will assess the effect of age and severe comorbidity on clinical course of RSV disease. A population size of 1000 older adults age \>60 years presenting with acute respiratory symptoms to the general practitioner (GP) during RSV season will be tested for RSV as part of routine care. We expect about 100 RSV+. Based on our sample size calculation, 100 RSV+ cases would provide sufficient accuracy for estimating the relevant outcomes.
Study Type
OBSERVATIONAL
Enrollment
100
University Medical Center Utrecht
Utrecht, Netherlands
RECRUITINGBurden of medically attended RSV infection in the Dutch primary care
The burden of medically attended RSV infection in the Dutch primary care setting will be defined as severity and duration of clinical symptoms, and healthcare resource use.
Time frame: Data will be collected at three timepoints (Day 0, Day 14 and Day 30 days after viral swab)
RSV-related health care consumption and indirect costs in older adults
Health care utilization will be calculated as the number of contact moments (including phone contacts, telemedicine and visits) with the GP-practices and other health-care providers (e.g. visit to specialist, emergency department). For hospitalized adults, the number of admitted days and the level of care (general ward, high dependency unit, intensive care unit) will be calculated. Medical costs and socio-economic costs will be calculated based on the questionnaires at day 0, 14 and day 30.
Time frame: Data will be collected at three timepoints (Day 0, Day 14 and Day 30 days after viral swab)
Proportion of medically attended RSV infection amongst all medically attended acute respiratory infections in older adults in the primary care setting
The proportion of RSV positive older adults will be calculated as the number of older adults who tested positive for RSV divided by the total number of older adults who visit the participating GP practices because of ARTIs and were tested for RSV.
Time frame: At day of sampling (Day 0)
Association between disease severity and several clinical and demographic parameters (e.g. age, cardiopulmonary comorbidity, smoking status, chronic immunosuppressive medication use) and RSV burden (by disease severity and healthcare usage)
We will explore potential risk factors ((e.g. age, cardiopulmonary comorbidity, smoking status, polypharmacy, chronic immunosuppressive medication use) for severe RSV disease.
Time frame: Data will be collected at three timepoints (Day 0, Day 14 and Day 30 after viral swab)
Incidence of RSV-related secondary bacterial pneumonia events and antibiotic use
Incidence will be calculated as the proportion of subjects that show RSV-associated secondary bacterial pneumonia events (defined as pneumonia within 21 days after RSV infection) and antibiotic use.
Time frame: Data will be collected at the last timepoint (30 days after viral swab)
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