Introduction During the first wave of the coronavirus-disease 2019 (covid-19) pandemic in early 2020, hydroxychloroquine (HCQ) was widely prescribed in light of in vitro activity against severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2). Our objective was to evaluate in early 2020 the rate of French hospitalists declaring having prescribed HCQ to treat covid-19 patients outside any therapeutic trial, compare the reasons and the determinants for having prescribed HCQ or not. Material and methods A national inquiry submitted by email from May 7 to 25, 2020, to a sample of French hospitalists: doctors managing patients hospitalized for covid-19 in a French department of internal medicine or infectious diseases and identified in the directories of French hospitals or as a member of the French Infectious Diseases Society (SPILF). Primary outcome was the percentage of hospitalists declaring having prescribed HCQ to covid-19 patients. Secondary outcomes were reasons and determinants of HCQ prescription. Results Among 400 (22.8%) responding hospitalists, 45.3% (95% CI, 40.4 to 50.1%) declared having prescribed HCQ to covid-19 patients. Two main profiles were discerned: HCQ prescribers who did not raise its efficacy as a motive, and non-prescribers who based their decision on evidence-based medicine. Multivariate analysis retained the following prescription determinants (adjusted odds ratio; 95% confidence interval): a departmental procedure for HCQ prescription (8.25; 4.79 to 14.20), having prescribed other treatments outside a therapeutic trial (3.21; 1.81 to 5.71), prior HCQ prescription (2.75; 1.5 to 5.03) and HCQ prescribed within the framework of a therapeutic trial (0.56; 0.33 to 0.95). Conclusion Almost half of the hospitalists prescribed HCQ. The physician’s personality (questioning or not evidence-based–medicine principles in the context of the pandemic) and departmental therapeutic procedures were the main factors influencing HCQ prescription. Establishment of “therapeutic” procedures represents a potential means to improve the quality of therapeutic decision-making during a pandemic.
【초록키워드】 SARS-CoV-2, Efficacy, pandemic, Infectious diseases, Trial, Hydroxychloroquine, hospital, Infectious disease, outcome, Severe acute respiratory syndrome, Evidence-based medicine, therapeutic, Patient, HCQ, determinants, respiratory, First wave, patients, Multivariate analysis, in vitro activity, internal medicine, framework, therapeutic trial, determinant, Society, acute respiratory syndrome, Factor, adjusted odds ratio, Primary outcome, 95% CI, 95% confidence interval, Secondary outcomes, profile, email, other treatments, treat, material, member, National, French, inquiry, secondary, raise, IMPROVE, Result, evaluate, adjusted, submitted, retained, other treatment, patients hospitalized, 【제목키워드】 Trial, therapeutic, National, French, inquiry, hospitalized patient,