High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-II Receptor Blockers (ARBs) Initiators DOI Creative Commons
Asinamai Ndai, Kayla Smith, Shailina Keshwani

и другие.

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Март 11, 2025

Angiotensin-II Receptor Blockers (ARBs) are commonly prescribed; however, their adverse events may prompt new drug prescription(s), known as prescribing cascades. We aimed to identify potential ARB-induced cascades using high-throughput sequence symmetry analysis. Using claims data from a national sample of Medicare beneficiaries (2011-2020), we identified ARB users aged ≥66 years with continuous enrollment ≥360 days before and ≥180 after initiation. screened for initiation 446 other (non-antihypertensive) 'marker' classes within ±90 initiation, generating ratios (SRs) reflecting proportions starting the marker class versus Adjusted SRs (aSRs) accounted trends over time, significant aSRs, calculated naturalistic number needed harm (NNTH); signals were reviewed by clinical experts plausibility. 320,663 initiators (mean ± SD age 76.0 7.2 years; 62.5% female; 91.5% hypertension). Of evaluated, 17 significant, three (18%) classified review. The strongest ranked lowest NNTH included benzodiazepine derivatives (NNTH 2130, 95% CI 1437-4525), adrenergics in combination anticholinergics, including triple combinations corticosteroids 2656, 1585-10074), antianemic preparations 9416, 6606-23784). highest aSR (aSR 1.7, 1.19-2.41), 1.18, 1.08-1.3), 1.12, 1.03-1.22). cascade reflected possibly under-recognized this cohort. These hypothesis-generating findings require further investigation determine extent impact these on patient outcomes.

Язык: Английский

High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-II Receptor Blockers (ARBs) Initiators DOI Creative Commons
Asinamai Ndai, Kayla Smith, Shailina Keshwani

и другие.

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Март 11, 2025

Angiotensin-II Receptor Blockers (ARBs) are commonly prescribed; however, their adverse events may prompt new drug prescription(s), known as prescribing cascades. We aimed to identify potential ARB-induced cascades using high-throughput sequence symmetry analysis. Using claims data from a national sample of Medicare beneficiaries (2011-2020), we identified ARB users aged ≥66 years with continuous enrollment ≥360 days before and ≥180 after initiation. screened for initiation 446 other (non-antihypertensive) 'marker' classes within ±90 initiation, generating ratios (SRs) reflecting proportions starting the marker class versus Adjusted SRs (aSRs) accounted trends over time, significant aSRs, calculated naturalistic number needed harm (NNTH); signals were reviewed by clinical experts plausibility. 320,663 initiators (mean ± SD age 76.0 7.2 years; 62.5% female; 91.5% hypertension). Of evaluated, 17 significant, three (18%) classified review. The strongest ranked lowest NNTH included benzodiazepine derivatives (NNTH 2130, 95% CI 1437-4525), adrenergics in combination anticholinergics, including triple combinations corticosteroids 2656, 1585-10074), antianemic preparations 9416, 6606-23784). highest aSR (aSR 1.7, 1.19-2.41), 1.18, 1.08-1.3), 1.12, 1.03-1.22). cascade reflected possibly under-recognized this cohort. These hypothesis-generating findings require further investigation determine extent impact these on patient outcomes.

Язык: Английский

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