Evaluation of COVID-19 treatments in Iran in comparison with local therapeutic recommendations: A population-level study on utilization and costs of prescription drugs

Yaghoubifard, Saeed; Hashemi-Meshkini, Amir; Koochak, Reza; Nikfar, Shekoufeh; Rezaei-Darzi, Ehsan

doi:10.4103/jrpp.jrpp_6_22

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…Health claims data is a rich source of information on the diagnosis of different diseases, pharmacological and non-pharmacological treatments for diseases, out-patient and in-patient visits, and other associated data which is used by health systems and insurance companies to track the overall performance of the health authorities and it has shown that its data is a valuable tool to measure the quality of provided care ( 9 , 10 ). While previous ecological studies used medication sales data to estimate drug prescription patterns and their adherence to clinical guidelines, using health claims data as individual-based database, could offer a deeper understanding of evidence-based treatment and its changes over time ( 11 , 12 ). In the case of COVID-19, the claims data proved effective in drawing different aspects of disease management and its impact on patient outcomes ( 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data

Mehrizi,

Golestani,

Malekpour

et al. 2023

Front. Public Health

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BackgroundDifferent medication prescription patterns have been associated with varying course of disease and outcomes in COVID-19. Health claims data is a rich source of information on disease treatment and outcomes. We aimed to investigate drug prescription patterns and their association with mortality and hospitalization via insurance data for a relatively long period of the pandemic in Iran.MethodsWe retrieved hospitalized patients’ data from Iran Health Insurance Organization (IHIO) spanning 26 months (2020–2022) nationwide. Included were patients with ICD-10 codes U07.1/U07.2 for confirmed/suspected COVID-19. A case was defined as a single hospitalization event for an individual patient. Multiple hospitalizations of a patient within a 30-day interval were aggregated into a single case, while hospitalizations with intervals exceeding 30 days were treated as independent cases. The Anatomical Therapeutic Chemical (ATC) was used for medications classification. The two main study outcomes were general and intensive care unit (ICU) hospitalization periods and mortality. Besides, various demographic and clinical associate factors were analyzed to derive the associations with medication prescription patterns and study outcomes using accelerated failure time (AFT) and logistic regression models.ResultsDuring the 26 months of the study period, 1,113,678 admissions with COVID-19 diagnosis at hospitals working in company with IHIO were recorded. 917,198 cases were detected from the database, among which 51.91% were females and 48.09% were males. Among the main groups of medications, antithrombotics (55.84% [95% CI: 55.74–55.94]), corticosteroids (54.14% [54.04–54.24]), and antibiotics (42.22% [42.12–42.32]) were the top used medications among cases with COVID-19. Investigation of the duration of hospitalization based on main medication groups showed antithrombotics (adjusted median ratio = 0.94 [0.94–0.95]) were significantly associated with shorter periods of overall hospitalization. Also, antithrombotics (adjusted odds ratio = 0.74 [95%CI, 0.73–0.76]), corticosteroids (0.97 [0.95–0.99]), antivirals (0.82 [0.80–0.83]), and ACE inhibitor/ARB (0.79 [0.77–0.80]) were significantly associated with lower mortality.ConclusionOver 2 years of investigation, antithrombotics, corticosteroids, and antibiotics were the top medications for hospitalized patients with COVID-19. Trends in medication prescription varied based on various factors across the country. Medication prescriptions could potentially significantly impact the trends of mortality and hospitalization during epidemics, thereby affecting both health and economic burdens.

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Section: Introductionmentioning

confidence: 99%

Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data

Mehrizi,

Golestani,

Malekpour

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

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Challenges of antiviral therapy on clinical outcomes and 30-day survival benefits in hospitalized multiple sclerosis patients with COVID-19

Maghbooli,

Kasaeian,

Fattahi

et al. 2023

Preprint

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Background: This study aimed to evaluate the efficacy and safety concerns of remdesivir and type 1 interferons (INFs) on the clinical outcomes of multiple sclerosis (MS) patients who were hospitalized with COVID-19. Methods: Using electronic health records systems, this is a cross-sectional study of two years of hospital admissions in terms of COVID-19 in Iran from March 2019 to August 2021. The severities of COVID-19 outcomes were ICU admission, hospitalization days, and 30-day mortality rates. Results: Nine hundred ninety-nine hospitalized MS patients with a definite diagnosis of COVID-19 based on PCR were recorded in the electronic health systems. Almost half of the patients were under treatment with an anti-CD-20 agent (rituximab or ocrelizumab) at the time of hospital admission (50.3%), with higher mortality rates, needing ICU admission, and longer hospitalization (p<0.05). There was a significant association between taking IFN alone (adjusted IRR=1.21, 95% CI 1.32 to 1.42) or in combination with RDV (adjusted IRR=1.30, 95% CI 1.18 to 1.5042) and longer hospitalization. There were no significant associations between antiviral treatment (RDV alone, IFNβ1 alone, and IFNβ1 plus RDV) and ICU admission (p>0.2), in-hospital mortality rate (p>0.2), or 30-day survival rate (p>0.2). The results were similar in patients who did or did not receive anti-CD-20 agents. Conclusion: Our data reveal that RDV, IFN, or a combination of IFN and RDV administration has no benefit in the treatment of hospitalized MS patients with COVID-19.

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Evaluation of COVID-19 treatments in Iran in comparison with local therapeutic recommendations: A population-level study on utilization and costs of prescription drugs

Cited by 2 publications

References 19 publications

Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data

Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data

Challenges of antiviral therapy on clinical outcomes and 30-day survival benefits in hospitalized multiple sclerosis patients with COVID-19

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