This retrospective study aims to perform a medication risk stratification using drug claims data and to simulate the impact of the addition of various repurposed drugs on the Medication Risk Score (MRS) in elderly people enrolled in PACE organizations. Our clinical tool would enable to identify potential multi-drug interactions and potentially reduce the risk of adverse drug events (ADE) developing in elderly patients infected with COVID-19.
Certain investigational agents have been described in observational series or are being used
anecdotally based on in vitro or extrapolated evidence. It is important to acknowledge that
there are no controlled data supporting the use of any of these agents, and their efficacy
for COVID-19 is unknown. FDA-approved drugs such as chloroquine/hydroxychloroquine,
lopinavir/ritonavir, monoclonal IL-6 antibodies, JAK inhibitors, thalidomide and the new
investigational drug, remdesivir have been proposed for repurposing to fight COVID-19 and its
complications.
A medication risk stratification strategy will be used to simulate the impacts of different
potential repurposed drugs for COVID-19 on the Medication Risk Score (MRS) which is used as a
predictive tool for ADEs. A retrospective study will be conducted using de-identified drug
claims data of elderly patients with polypharmacy.
Patients meeting all the following criteria will be included:
1. Patient enrolled in a PACE organization during the implementation period;
2. PACE organization contractually receiving pharmacy services from CareKinesis;
Exclusion Criteria
a) No drug claims data available for the period of 2019-2020
This retrospective cohort will utilize 178,867 drug claims from approximately 12,123 patients
enrolled in PACE. MRS will be calculated using the last available 3-month period of drug
claims in 2019. The data elements required for the calculation of the full set of risk scores
are: prescribed drugs, dose, age, gender. Medication risk stratification using 5 factors will
be performed to obtain the MRS. Various repurposed drugs (drugs associated with the highest
probability or efficacy or shown interest as per their inclusion in current clinical trials
will be prioritized) will be added to the patient drug regimen except for the patients that
are currently taking the repurposed drug. A new MRS will be generated for all stratified
patients.
Other: Simulation of Repurposed Drugs for COVID-19
This study is a simulation of adding repurposed drugs for COVID-19. We are using drug claims, and will not intervene with patient care.
Other Name: Simulation using proprietary risk stratification software
Inclusion Criteria:
- Patient enrolled in a PACE organization during the implementation period;
- PACE organization contractually receiving pharmacy services from CareKinesis;
Exclusion Criteria:
- No drug claims data available for the period of 2019-2020
Tabula Rasa HealthCare Precision Pharmacotherapy Research and Development Institute
Orlando, Florida, United States
Veronique Michaud, PhD, Principal Investigator
Tabula Rasa HealthCare