Cargando…

Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study

Unmanaged pharmacogenomic and drug interaction risk can lengthen hospitalization and may have influenced the severe health outcomes seen in some COVID-19 patients. To determine if unmanaged pharmacogenomic and drug interaction risks were associated with longer lengths of stay (LOS) among patients ho...

Descripción completa

Detalles Bibliográficos
Autores principales: Ashcraft, Kristine, Moretz, Chad, Schenning, Chantelle, Rojahn, Susan, Vines Tanudtanud, Kae, Magoncia, Gwyn Omar, Reyes, Justine, Marquez, Bernardo, Guo, Yinglong, Erdemir, Elif Tokar, Hall, Taryn O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617857/
https://www.ncbi.nlm.nih.gov/pubmed/34834543
http://dx.doi.org/10.3390/jpm11111192
_version_ 1784604607499993088
author Ashcraft, Kristine
Moretz, Chad
Schenning, Chantelle
Rojahn, Susan
Vines Tanudtanud, Kae
Magoncia, Gwyn Omar
Reyes, Justine
Marquez, Bernardo
Guo, Yinglong
Erdemir, Elif Tokar
Hall, Taryn O.
author_facet Ashcraft, Kristine
Moretz, Chad
Schenning, Chantelle
Rojahn, Susan
Vines Tanudtanud, Kae
Magoncia, Gwyn Omar
Reyes, Justine
Marquez, Bernardo
Guo, Yinglong
Erdemir, Elif Tokar
Hall, Taryn O.
author_sort Ashcraft, Kristine
collection PubMed
description Unmanaged pharmacogenomic and drug interaction risk can lengthen hospitalization and may have influenced the severe health outcomes seen in some COVID-19 patients. To determine if unmanaged pharmacogenomic and drug interaction risks were associated with longer lengths of stay (LOS) among patients hospitalized with COVID-19, we retrospectively reviewed medical and pharmacy claims from 6025 Medicare Advantage members hospitalized with COVID-19. Patients with a moderate or high pharmacogenetic interaction probability (PIP), which indicates the likelihood that testing would identify one or more clinically actionable gene–drug or gene–drug–drug interactions, were hospitalized for 9% (CI: 4–15%; p < 0.001) and 16% longer (CI: 8–24%; p < 0.001), respectively, compared to those with low PIP. Risk adjustment factor (RAF) score, a commonly used measure of disease burden, was not associated with LOS. High PIP was significantly associated with 12–22% longer LOS compared to low PIP in patients with hypertension, hyperlipidemia, diabetes, or chronic obstructive pulmonary disease (COPD). A greater drug–drug interaction risk was associated with 10% longer LOS among patients with two or three chronic conditions. Thus, unmanaged pharmacogenomic risk was associated with longer LOS in these patients and managing this risk has the potential to reduce LOS in severely ill patients, especially those with chronic conditions.
format Online
Article
Text
id pubmed-8617857
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-86178572021-11-27 Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study Ashcraft, Kristine Moretz, Chad Schenning, Chantelle Rojahn, Susan Vines Tanudtanud, Kae Magoncia, Gwyn Omar Reyes, Justine Marquez, Bernardo Guo, Yinglong Erdemir, Elif Tokar Hall, Taryn O. J Pers Med Article Unmanaged pharmacogenomic and drug interaction risk can lengthen hospitalization and may have influenced the severe health outcomes seen in some COVID-19 patients. To determine if unmanaged pharmacogenomic and drug interaction risks were associated with longer lengths of stay (LOS) among patients hospitalized with COVID-19, we retrospectively reviewed medical and pharmacy claims from 6025 Medicare Advantage members hospitalized with COVID-19. Patients with a moderate or high pharmacogenetic interaction probability (PIP), which indicates the likelihood that testing would identify one or more clinically actionable gene–drug or gene–drug–drug interactions, were hospitalized for 9% (CI: 4–15%; p < 0.001) and 16% longer (CI: 8–24%; p < 0.001), respectively, compared to those with low PIP. Risk adjustment factor (RAF) score, a commonly used measure of disease burden, was not associated with LOS. High PIP was significantly associated with 12–22% longer LOS compared to low PIP in patients with hypertension, hyperlipidemia, diabetes, or chronic obstructive pulmonary disease (COPD). A greater drug–drug interaction risk was associated with 10% longer LOS among patients with two or three chronic conditions. Thus, unmanaged pharmacogenomic risk was associated with longer LOS in these patients and managing this risk has the potential to reduce LOS in severely ill patients, especially those with chronic conditions. MDPI 2021-11-12 /pmc/articles/PMC8617857/ /pubmed/34834543 http://dx.doi.org/10.3390/jpm11111192 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ashcraft, Kristine
Moretz, Chad
Schenning, Chantelle
Rojahn, Susan
Vines Tanudtanud, Kae
Magoncia, Gwyn Omar
Reyes, Justine
Marquez, Bernardo
Guo, Yinglong
Erdemir, Elif Tokar
Hall, Taryn O.
Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study
title Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study
title_full Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study
title_fullStr Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study
title_full_unstemmed Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study
title_short Unmanaged Pharmacogenomic and Drug Interaction Risk Associations with Hospital Length of Stay among Medicare Advantage Members with COVID-19: A Retrospective Cohort Study
title_sort unmanaged pharmacogenomic and drug interaction risk associations with hospital length of stay among medicare advantage members with covid-19: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617857/
https://www.ncbi.nlm.nih.gov/pubmed/34834543
http://dx.doi.org/10.3390/jpm11111192
work_keys_str_mv AT ashcraftkristine unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT moretzchad unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT schenningchantelle unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT rojahnsusan unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT vinestanudtanudkae unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT magonciagwynomar unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT reyesjustine unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT marquezbernardo unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT guoyinglong unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT erdemireliftokar unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy
AT halltaryno unmanagedpharmacogenomicanddruginteractionriskassociationswithhospitallengthofstayamongmedicareadvantagememberswithcovid19aretrospectivecohortstudy