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.
【저자키워드】 COVID-19, Hospitalization, precision medicine, pharmacogenomics, Length of stay, medication management, healthcare administration, healthcare costs, hierarchical conditions category (HCC), risk adjustment factor (RAF), 【초록키워드】 Hospitalized, risk, diabetes, outcome, hypertension, COPD, Probability, Health, Patient, disease, moderate, interactions, COVID-19 patients, pulmonary disease, Interaction, drug interaction, chronic conditions, LOS, severely ill patients, hyperlipidemia, Medicare, likelihood, greater, identify, significantly, clinically, indicate, determine, reduce, chronic obstructive, patients hospitalized, pharmacogenetic, PIP, with COVID-19, 【제목키워드】 drug, member, Medicare, Length,