The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions: Preliminary Results from a Real-World Healthcare System.

The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions: Preliminary Results from a Real-World Healthcare System.
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药物遗传学药物相互作用对90天再入院的贡献:来自现实世界医疗保健系统的初步结果。

DOI:
10.3390/jpm11121242
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发表时间:
2021-11-23
影响因子:
--
通讯作者:
Dunnenberger HM
Dunnenberger HM
中科院分区:
医学4区
文献类型:
--
作者:
David SP;Singh L;Pruitt J;Hensing A;Hulick P;Meltzer DO;O'Donnell PH;Dunnenberger HM

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临床药物遗传学实施联盟(CPIC)的指南存在于出院前常用的许多药物中,但关于基因-x-药物相互作用对再入院的贡献的数据有限。本研究评估了2010年至2020年期间接受14基因药物遗传学测序的研究人群(N = 10,104)中入院后30天内开出的CPIC药物处方与90天再次入院之间的关系。面板。在入院后30天内处方的药物中存在至少一种药物遗传学指标被认为是基因-x-药物相互作用。多变量逻辑回归分析了一个或多个基因-x-药物相互作用与90天再入院之间的关系。2211/2354(93.9%)例住院患者至少接受了一种CPIC药物治疗。单变量分析表明,存在至少一种确定的基因-x-药物相互作用使90天再入院的风险增加40%以上(OR = 1.42,95%置信区间(CI)1.09-1.84)(p = 0.01)。调整年龄、种族、性别、就业状况、体重指数和医疗状况的多变量模型略微减弱了该效应(OR = 1.32,95% CI 1.02-1.73)(p = 0.04)。我们的研究结果表明,存在一种或多种CPIC基因-X-药物相互作用会增加90天再入院的风险,即使在调整人口统计学和临床风险因素后也是如此。
Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines exist for many medications commonly prescribed prior to hospital discharge, yet there are limited data regarding the contribution of gene-x-drug interactions to hospital readmissions. The present study evaluated the relationship between prescription of CPIC medications prescribed within 30 days of hospital admission and 90-day hospital readmission from 2010 to 2020 in a study population (N = 10,104) who underwent sequencing with a 14-gene pharmacogenetic panel. The presence of at least one pharmacogenetic indicator for a medication prescribed within 30 days of hospital admission was considered a gene-x-drug interaction. Multivariable logistic regression analyzed the association between one or more gene-x-drug interactions with 90-day readmission. There were 2211/2354 (93.9%) admitted patients who were prescribed at least one CPIC medication. Univariate analyses indicated that the presence of at least one identified gene-x-drug interaction increased the risk of 90-day readmission by more than 40% (OR = 1.42, 95% confidence interval (CI) 1.09–1.84) (p = 0.01). A multivariable model adjusting for age, race, sex, employment status, body mass index, and medical conditions slightly attenuated the effect (OR = 1.32, 95% CI 1.02–1.73) (p = 0.04). Our results suggest that the presence of one or more CPIC gene-x-drug interactions increases the risk of 90-day hospital readmission, even after adjustment for demographic and clinical risk factors.
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