Mayo Clinic proceedings. Innovations, quality & outcomes · 2025
A Randomized Trial of At-Home COVID-19 Tests, Telemedicine, and Rapid Prescription Delivery for Immunocompromised Individuals.
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Vogel Julia Moore, Hung Ting-Yang, Coughlin Erin, Delgado Felipe, Kheterpal Vik, Quer Giorgio, Topol Eric
Аннотация
OBJECTIVE: To evaluate whether access to at-home COVID-19 tests, telemedicine, and same-day prescription delivery could reduce COVID cases, hospitalizations, and the cost of COVID care for the high-risk populations using a randomized controlled trial.
PATIENTS AND METHODS: Individuals participated remotely between December 1, 2022, and May 16, 2024, with half (n=346, 51.5%) receiving the option to access 10 at-home COVID-19 tests per month for themselves and others in their household as well as telemedicine and same-day Paxlovid delivery, and half (n=325, 48.4%) following their standard testing and treatment practices. Outcome data were collected from surveys, electronic health records and claims.
RESULTS: Intensive care unit admissions were significantly reduced for intervention participants vs control participants (0.3% vs 4.6%, n=1 vs 13; P<.001). Reported COVID case incidence did not differ significantly (19.0% vs 20.4%, n=59 vs 58; P=.69), nor did hospitalizations (5.2% vs 7.7%, n=15 vs 22; P=.14). The intervention was estimated to result in a reduction of $3650 in the cost of COVID care per person. The specific intervention used is no longer available in the market and alternatives should be considered. Evolution of SARS-CoV-2 could change the effect observed. Survey completion was higher in the intervention group.
CONCLUSION: In immunocompromised individuals and those at least aged 65 years, access to at-home COVID tests, telemedicine, and rapid Paxlovid delivery reduced the severity of COVID-19 infections, as reflected by a reduced need for intensive care unit admissions; this has the potential to reduce the cost of COVID care.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT05655546.
PATIENTS AND METHODS: Individuals participated remotely between December 1, 2022, and May 16, 2024, with half (n=346, 51.5%) receiving the option to access 10 at-home COVID-19 tests per month for themselves and others in their household as well as telemedicine and same-day Paxlovid delivery, and half (n=325, 48.4%) following their standard testing and treatment practices. Outcome data were collected from surveys, electronic health records and claims.
RESULTS: Intensive care unit admissions were significantly reduced for intervention participants vs control participants (0.3% vs 4.6%, n=1 vs 13; P<.001). Reported COVID case incidence did not differ significantly (19.0% vs 20.4%, n=59 vs 58; P=.69), nor did hospitalizations (5.2% vs 7.7%, n=15 vs 22; P=.14). The intervention was estimated to result in a reduction of $3650 in the cost of COVID care per person. The specific intervention used is no longer available in the market and alternatives should be considered. Evolution of SARS-CoV-2 could change the effect observed. Survey completion was higher in the intervention group.
CONCLUSION: In immunocompromised individuals and those at least aged 65 years, access to at-home COVID tests, telemedicine, and rapid Paxlovid delivery reduced the severity of COVID-19 infections, as reflected by a reduced need for intensive care unit admissions; this has the potential to reduce the cost of COVID care.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT05655546.