Press Releases: Week of 4/13

Sermo Reports: One-Quarter of Global Physicians Agree That Healthcare Workers Should Take Hydroxychloroquine to Prevent COVID-19 Infections; Use of Hydroxychloroquine in Prophylaxis and Even in Undiagnosed Suspected Patient Cases is Seen

Sermo’s Barometer studies have polled over 20,000 physicians globally regarding COVID-19

New York – April 17, 2020 – Hydroxychloroquine, a widely available and inexpensive drug initially used for malaria as well as lupus and rheumatoid arthritis, has been the subject of intense medical and political debate as researchers work quickly to determine its ability to fight coronavirus. According to this week’s Sermo COVID-19 Real Time Barometer of 5,158 physicians, one-quarter of global physicians agree that healthcare workers should take hydroxychloroquine to prevent COVID-19 infections with 50% having used or seen hydroxychloroquine used in their professional settings since March 25, 2020.

There is little data about the efficacy of hydroxychloroquine, and the Centers for Disease Control and Prevention (CDC) has cited cardiotoxicity as a leading concern with the treatment, particularly in patients with underlying health issues and immunosuppression.


Hydroxychloroquine use among patients:

In the US alone, there are more than 24 hydroxychloroquine trials underway to test the drug’s capabilities for preventing and treating coronavirus. While universities like NYU Langone Medical School are evaluating whether hydroxychloroquine can prevent people exposed to the novel coronavirus from getting sick and states like South Dakota are conducting their own clinical trials, physicians are increasingly tasked with making real-time decisions based on the limited information available.


Prophylactic use of Hydroxychloroquine for patients:

By the first week of April 2020, of the physicians who had prescribed hydroxychloroquine to their patients, 22% of them had already prescribed or had seen hydroxychloroquine prescribed prophylactically in their setting (n=1443).


While most patient types receiving hydroxychloroquine were high risk (including first responders), a significant share of physicians had even used hydroxychloroquine for low risk patients:

  • 87% of physicians indicated use in high risk patients, including first responders (n= 277)
  • 31% of physicians indicated use for low risk patients (n=100)


Hydroxychloroquine usage for suspected undiagnosed cases:

Findings from the Sermo study also reveal that physicians have prescribed hydroxychloroquine for both symptomatic patients and undiagnosed patients, and the use of hydroxychloroquine in clinical settings has been on the rise since March 25, 2020. As of April 8, 50% of global physicians have used or seen hydroxychloroquine used in their professional settings (Week 1, March 25: 33%; Week 2, April 1: 44%; Week 3, April 8th: 50%).

Additionally, physicians reported the patient types they are treating with hydroxychloroquine include:

  • Week 1 through Week 2 – 57% vs. 65% (respectively) of physicians used hydroxychloroquine for diagnosed patients with severe symptoms

  • Week 1 through Week 2 – 45% vs. 49% (respectively) of physicians used hydroxychloroquine for diagnosed patients with mild symptoms
  • Week 1 through Week 2 – 17% vs. 22% (respectively) of physicians used hydroxychloroquine for undiagnosed patients with severe symptoms
  • Week 1 through Week 2 – 16% of physicians used hydroxychloroquine for undiagnosed patients with mild symptoms

N= physicians who have prescribed hydroxychloroquine (W1: 2573, W2: 1443)

An anonymous emergency medicine physician on Sermo commented: “Despite the superstorm of controversy surrounding hydroxychloroquine, it still remains the leading treatment option for severe patients and is even being used in milder cases and patients who are simply suspected of COVID. At this stage with so little evidence, doctors have very limited options.”

Sermo’s COVID-19 Real Time Barometer observational study polled over 20,000 expert physicians in 30 countries, including the United States, Canada, United Kingdom, France, Brazil, Russia, China, Japan and Australia. All data published to date can be found here.


About Sermo

Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com.

Sermo Reports Week 3 Results: Globally 17% Point Increase in COVID Treaters Who Have Used Hydroxychloroquine (33%-50%) and Azithromycin (41%-58%)

Percentage of New York Physicians Who Have Used Hydroxychloroquine Nearly Doubled, Italian and French Physicians Jumped 30% Points + Over 2 Weeks

Plasma Still Perceived as Most Effective but Not Widely Used

Perception of Hydroxychloroquine’s Efficacy is Significantly Higher Among Physicians in Europe and China vs US Physicians (50% vs 29%)

New York, New York – April 15, 2020 – Week three data of the Barometer study from 4016 physicians in 30 countries conducted by Sermo reveals the emergence of treatment patterns and efficacy perceptions. Sermo, the largest global healthcare polling company and social platform for physicians, has published unrestricted access to the results of its Real Time Barometer study on sermo.com.


Key findings:

In Wave 3 we explored perceptions of physicians who were high vs moderate vs low treaters of COVID patients. The total number of physician respondents for Wave 3 was 4016. Of those, 33% treated COVID patients (n=1337).

The COVID treaters (1337) breakdown was:

  • 42% of COVID treaters have treated between 1-5 patients
  • 20% of COVID treaters have treated between 6 -10 patients
  • 38% of COVID treaters have treated between 11 and more patients

We did not find significant differences between highly active and low active COVID treaters in the below findings.


Usage patterns among COVID treaters (N= 1337)

  • The top three treatments that doctors reported having prescribed were Azithromycin (58%), Hydroxychloroquine (50%), and Bronchodilators (48%); traditional Chinese medicine has been used by 67% of physicians in China.


Week over week increases in usage

  • Percentage of physicians in New York who have used Hydroxychloroquine nearly doubled since Wave 1 week of March 25 (23% to 40% to 43% wave over wave).
  • Italy and France had the highest increase in COVID treaters having prescribed Hydroxychloroquine wave over wave; an increase from 50% to 83% for Italy and an increase from 20% to 50% for France.
  • The number of COVID treaters that report having used Hydroxychloroquine and Azithromycin both increased 17% points since Wave 1 the week of March 25.
    • Hydroxychloroquine Wave 1: 33%, Wave 2: 44%, Wave 3: 50%
    • Azithromycin Wave 1: 41%, Wave 2: 50%, Wave 3: 58%
  • The number of COVID treaters that report having used Bronchodilators increased 12% points (from 36% to 48%) week over week.
  • Usage of anti-HIV drugs (e.g. Lopinavir plus Ritonavir), drugs to treat the flu (e.g. Oseltamivir), and plasma from recovered patients remains steady week over week, while use of non-approved drugs (e.g. Remdesivir) decreased slightly.


Perceived treatment efficacy

  • Physicians who treat COVID patients in Italy, Spain, France, and China have higher perceptions of Hydroxychloroquine’s efficacy vs the US (~50% vs 29%).
  • The top treatments that have been used/seen used and reported as very or extremely effective among COVID treaters (N= 1337) include:
    • 46% plasma from recovered patients (n=363); 40% Hydroxychloroquine (n=875); 38% high dose steroids during a cytokine storm (n=556)
    • No significant differences of perceived efficacy were observed between highly active COVID treaters and users of these drugs (physicians treating 11+ patients) and lower active COVID treaters (1-10 patients)
    • 55% of physicians in China who have used traditional Chinese medicine rated traditional Chinese medicine as effective or extremely effective


Most popular Hydroxychloroquine dosage regimen

  • 75% report using 400mg BID on day one (800mg total), then 400 mg daily for 4-5 days
  • 10% report using 600mg BID on day one (1,200mg total), then 400 mg daily for 4 days


Methodology

Most results are reported for individual countries with a minimum sample size of 250. A sample size of 250 point estimates have a precision of a +/- 6% precision at a 94% confidence level. Where sample sizes are smaller, N sizes are noted. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology.


About Sermo

Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com.


Media Contact:

Niki Franklin
Racepoint Global on behalf of Sermo
+1 617 624 3264
Sermo@racepointglobal.com

Sermo reports on life or death decisions: US physicians are 3 times as likely to say do-not-resuscitate should be the protocol for COVID patients who code vs physicians in other countries

69% of hospital physicians globally say their hospitals have already adjusted ventilator prioritization policy in case of shortages; US behind other countries

New York, New York – April 13, 2020 – The COVID-19 pandemic has put unprecedented pressure on global healthcare systems and created wartime triaging challenges that most healthcare providers have never faced. To put these situations into context, Sermo, the largest global healthcare polling company and social platform for physicians, is leveraging its capabilities to publish ongoing COVID-19 studies* with thousands of global physicians.

What to do if a patient codes

In typical medical emergencies when a patient codes, physicians use all measures to save a patient’s life. That effort requires that many HCPs work on the patient at once using techniques like de-intubation where bodily fluids from the patient can potentially spread and infect the healthcare team. Today, with the risk of infection to first responders, the “all measures“ approach seems to have changed.  

Sermo’s study reveals that over half of global physicians felt the HCP team should limit their exposure when trying to save patients’ lives. When asked, “what do you personally believe should be the protocol for COVID-19 patients that code,” the 4,982 global physician respondents said:

  • 53% – use all measures to save the patient’s life, but limit the number of healthcare professionals working on the patient
  • 26% – use all measures to save the patient’s life, with as many healthcare professionals as needed
  • 10% – do not resuscitate
  • 11% – do not know

Resuscitate or Do NOT Resuscitate? Regional differences in DNR approach

Physicians in the US are almost 3 times as likely to say ‘do not resuscitate (US 14% vs ROW 5%; n= 4982) 

Ventilator prioritization policies in hospitals have changed

Overall, 69% of hospital physicians globally reported their hospital has already adjusted the protocol for who receives a ventilator if they are in short supply (n=892 COVID treaters in hospitals). This appears to have happened earlier in Europe and ROW at ~75%, versus US at 53% and NY at 55%.

How hospital administrators and ethicists prioritize the use of ventilators; how doctors personally believe ventilators should be prioritized

We surveyed both physicians and hospitals on both their personal ethical beliefs regarding who should be prioritized for ventilator use and also asked them how their hospitals are making the same decisions. The criteria for deciding ventilator assignment included patients with the highest chance of recovery, patient most ill and at highest risk of death, first responders, age of the patient, and first come first serve.

Physicians’ personal ethical criteria versus hospitals’ ethical criteria for treating patients in a ventilator shortage

  • In choosing a hierarchy for the use of a ventilator for COVID-19 patients, physicians and hospitals agree on the first and second priority – 1, patients with the highest chance of recovery and 2, those most ill and highest risk of death.
  • However, they differ slightly on the third criteria: physicians personally believe first responders should have more priority over the age of the patient, whereas hospitals believe age of the patient should be prioritized over first responders.
  • First come first serve and age of patient were reported to be the least important criteria overall.

Physician ethical beliefs differ by country

The first wave of Sermo’s study data showed that among physicians in all countries except China, the top criteria for deciding who should receive a ventilator first was patients with the highest chance of recovery (47%) followed by those most ill and at highest risk of death (21%), and then first responders (15%).

With the pandemic changing so rapidly, Sermo re-polled the physicians on this question and the Wave II data showed an increase in prioritizing those with the highest chance of recovery across the globe:

  • 52% prioritized those with the highest chance of recovery
  • 21% those most ill and at highest risk of death
  • 14% first responders
  • 8% age of the patient
  • 5% first come first serve

“The insights gleaned from our platform provide a direct country-specific view into how physicians are responding to this pandemic. While similar challenges are global in nature, responses vary and tension points around the ethical decisions these physicians are facing come to light,” said Peter Kirk, CEO, Sermo.

 The second study wave represents more than 4,982 physicians in 30 countries. The data focuses on questions around ethical dilemmas, such as ventilator shortages, physician decisions on patient prioritization, what to do if a patient codes, and more. The data also analyzes differences in response to these dilemmas by country. To view full results and country breakdowns, visit sermo.com. *Results provide physician observations but are not a substitute for official medical guidelines. 

Methodology

Results are reported for individual countries with a minimum sample size of 250. Such a sample size provides for point estimates with a +/- 6% precision at a 94% confidence level.  Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology.

About Sermo

Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com.

Media Contact:

Niki Franklin
Racepoint Global on behalf of Sermo
+1 617 624 3264
Sermo@racepointglobal.com