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The effectiveness of interventions to reduce the transmission of acute respiratory infections in care homes: a systematic review

Summary

This systematic review examined effective ways to prevent respiratory infections like flu and COVID-19 in care homes where elderly residents live. The researchers found that antiviral medications like oseltamivir can halve the risk of influenza even in vaccinated residents if given within 7 days of detecting a case. High-dose vitamin D supplementation (100,000 IU monthly) reduced respiratory infection risk by 40%. Educational programs to improve staff hygiene practices showed mixed results, while other supplements like probiotics did not significantly help.

Background

Care home residents are at high risk from outbreaks of respiratory infections such as influenza and COVID-19 due to their age, comorbidities, and the communal environment that facilitates transmission. Over 45,000 care home residents died of COVID-19 during the pandemic. Standard infection control measures and vaccines alone may not be sufficient to prevent infections.

Objective

To conduct a systematic review of randomized controlled trials to determine which interventions apart from vaccines are effective at reducing transmission of acute respiratory infections in care homes.

Results

Twenty-one articles met inclusion criteria. Oseltamivir significantly reduced symptomatic laboratory-confirmed influenza (OR 0.39) and influenza-like illness (OR 0.50). High-dose vitamin D3 supplementation (100,000 IU monthly) reduced acute respiratory infection incidence (IRR 0.60). Educational interventions to improve infection control showed mixed results with only one study showing pneumonia reduction.

Conclusion

Transmission of respiratory infections in care homes can be reduced by educational interventions improving infection control, antiviral prophylaxis soon after case detection, and high-dose vitamin D3 supplementation. However, further research is needed to confirm vitamin D3 effectiveness and improve implementation of evidence-based practices.
  • Published in:Journal of Public Health,
  • Study Type:Systematic Review,
  • Source: PMID: 39136085, DOI: 10.1093/pubmed/fdae178
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