tetano
Editor, Senior Moderator
Sci Rep
. 2024 Mar 29;14(1):7485.
doi: 10.1038/s41598-024-57633-7. Predictors of nirmatrelvir-ritonavir receipt among COVID-19 patients in a large US health system
Deborah E Malden[SUP] 1 [/SUP], John M McLaughlin[SUP] 2 [/SUP], Vennis Hong[SUP] 3 [/SUP], Joseph Lewnard[SUP] 4 5 6 [/SUP], Bradley K Ackerson[SUP] 3 [/SUP], Laura Puzniak[SUP] 2 [/SUP], Jeniffer S Kim[SUP] 3 [/SUP], Harpreet Takhar[SUP] 3 [/SUP], Timothy B Frankland[SUP] 3 [/SUP], Jeff M Slezak[SUP] 3 [/SUP], Sara Y Tartof[SUP] 7 8 [/SUP]
Affiliations
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 Mar 29;14(1):7485.
doi: 10.1038/s41598-024-57633-7. Predictors of nirmatrelvir-ritonavir receipt among COVID-19 patients in a large US health system
Deborah E Malden[SUP] 1 [/SUP], John M McLaughlin[SUP] 2 [/SUP], Vennis Hong[SUP] 3 [/SUP], Joseph Lewnard[SUP] 4 5 6 [/SUP], Bradley K Ackerson[SUP] 3 [/SUP], Laura Puzniak[SUP] 2 [/SUP], Jeniffer S Kim[SUP] 3 [/SUP], Harpreet Takhar[SUP] 3 [/SUP], Timothy B Frankland[SUP] 3 [/SUP], Jeff M Slezak[SUP] 3 [/SUP], Sara Y Tartof[SUP] 7 8 [/SUP]
Affiliations
- PMID: 38553527
- PMCID: PMC10980791
- DOI: 10.1038/s41598-024-57633-7
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.