(HealthDay News) — Older adults are less likely than younger adults to have provider-ordered influenza testing, according to a study published online Jan. 17 in the Journal of the American Geriatrics Society.

Lauren Hartman, MD, from the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues collected data on patient demographics, symptoms, and provider-ordered influenza testing by questionnaire and chart review. Prospective laboratory-based surveillance was conducted using reverse-transcriptase polymerase chain reaction (RT-PCR) for diagnosis of influenza. Participants included 1422 adults aged 18 years and older with acute respiratory illness or non-localizing fever.

The researchers found that 28% of the patients had provider-ordered influenza testing. Compared to patients who were not tested, those who were tested were younger (58 ± 18 years vs 66 ± 15 years; P < 0.001) and were more likely to have influenza-like illness (ILI; 71 vs 49%; P < 0.001). There was an increase in ILI with decreasing age: 48, 60, and 63% for those aged ≥65 years, 50 to 64 years, and 18 to 49 years, respectively. ILI presence and younger age independently predicted provider-ordered testing among all patients. ILI was the only significant predictor of provider-ordered testing among the 136 patients with RT-PCR-confirmed influenza (adjusted odds ratio, 3.43).

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“Adults 65 years and older hospitalized with fever or respiratory symptoms during influenza season are less likely to have a provider-ordered influenza test than younger adults,” the authors write. “Further strategies are needed to increase clinician awareness and testing in this vulnerable group.”


  1. Hartman L, Zhu Y, Edwards KM, Griffin MR, and Talbot HP. Underdiagnosis of influenza virus infection in hospitalized older adults. J Am Geriatr Soc. 2018 Jan 17. doi: 10.1111/jgs.15298