Methods: Cerner HealthFacts, an electronic medical record with over 110 million hospitalizations, was used for this analysis (2005-2013). The study population was hospitalized US adults with MAT use. The first MAT used during any hospitalization was defined as the index triazole and index hospitalization. PDDIs were categorized using drug labels and DRUGDEX, an evidence-based system that classified interactions into 4 groups (contraindicated; major; moderate; minor). Minor PDDIs were not counted. A random hospitalization was chosen if a patient had multiple eligible hospitalizations. A PDDI event was considered to have occurred if both conditions were met: 1) used at least one drug with at least a moderate interaction classification with the index triazole during the index hospitalization and 2) there was at least a 1-day administration overlap between the index triazole and the given drug.
Results: 6962 hospitalizations were identified with MAT use, of which 6101 (87.6%) had evidence of a PDDI. 88% of voriconazole (n=4751), 86% of itraconazole (n=1784), and 93% of posaconazole (n=417) users had a PDDI. 26% of all hospitalizations with MAT use had at least 1 contraindicated PDDI, the most severe PDDI classification. 68% of hospitalizations with posaconazole, 34% of itraconazole, and 20% of voriconazole had at least 1 contraindicated PDDI. The most common drug interaction among all 3 MATs was with ondansetron.
Conclusion: Although this study could not directly assess the proportion of PDDIs that actually led to clinical events, the findings suggest that a majority of hospitalized patients receiving MATs were at risk for severe drug-drug interactions based on the concomitant medications assessed.
H. Yang, None
C. Kelley, None
R. D. Tan, None
Y. Zhong, None
B. Franks, Astellas: Employee , Salary
R. Kristy, None
E. Lee, Astellas: Employee , Salary
N. Khandelwal, None
J. Spalding, Astellas: Employee , Salary