Predictors of nirmatrelvir-ritonavir receipt among COVID-19 patients in a large US health system.

Autor:	Malden DE; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA. Debbie.E.Malden@kp.org., McLaughlin JM; Pfizer Inc, New York, USA., Hong V; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA., Lewnard J; Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA.; Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA.; Center for Computational Biology, College of Engineering, University of California, Berkeley, Berkeley, CA, 94720, USA., Ackerson BK; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA., Puzniak L; Pfizer Inc, New York, USA., Kim JS; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA., Takhar H; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA., Frankland TB; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA., Slezak JM; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA., Tartof SY; Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, Pasadena, CA, 91101, USA. Sara.Y.Tartof@kp.org.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, 91101, USA. Sara.Y.Tartof@kp.org.
Jazyk:	angličtina
Zdroj:	Scientific reports [Sci Rep] 2024 Mar 29; Vol. 14 (1), pp. 7485. Date of Electronic Publication: 2024 Mar 29.
DOI:	10.1038/s41598-024-57633-7
Abstrakt:	A clear understanding of real-world uptake of nirmatrelvir-ritonavir for treatment of SARS-CoV-2 can inform treatment allocation strategies and improve interpretation of effectiveness studies. We used data from a large US healthcare system to describe nirmatrelvir-ritonavir dispenses among all SARS-CoV-2 positive patients aged ≥ 12 years meeting recommended National Institutes of Health treatment eligibility criteria for the study period between 1 January and 31 December, 2022. Overall, 10.9% (N = 34,791/319,900) of treatment eligible patients with SARS-CoV-2 infections received nirmatrelvir-ritonavir over the study period. Although uptake of nirmatrelvir-ritonavir increased over time, by the end of 2022, less than a quarter of treatment eligible patients with SARS-CoV-2 infections had received nirmatrelvir-ritonavir. Across patient demographics, treatment was generally consistent with tiered treatment guidelines, with dispenses concentrated among patients aged ≥ 65 years (14,706/63,921; 23.0%), and with multiple comorbidities (10,989/54,431; 20.1%). However, neighborhoods of lower socioeconomic status (upper third of neighborhood deprivation index [NDI]) had between 12% (95% CI: 7-18%) and 28% (25-32%) lower odds of treatment dispense over the time periods studied compared to the lower third of NDI distribution, even after accounting for demographic and clinical characteristics. A limited chart review (N = 40) confirmed that in some cases a decision not to treat was appropriate and aligned with national guidelines to use clinical judgement on a case-by-case basis. There is a need to enhance patient and provider awareness on the availability and benefits of nirmatrelvir-ritonavir for the treatment of COVID-19 illness. (© 2024. The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Full text from SpringerLink