Medication utilization among COVID-19 patients in a large, national dataset: Cerner Real-World Dataâ„¢

Stroever, Stephanie J.; Ostapenko, Daniel; Scatena, Robyn; Pusztai, Daniel; Coritt, Lauren; Nee, Paul

PURPOSE: The outbreak of the novel coronavirus (COVID-19) required clinicians to use knowledge of therapeutic mechanisms of established drugs to piece together treatment regimens. The purpose of this study is to examine the trends in medication utilization among COVID-19 patients across the United States using a national dataset. METHODS: We conducted a cross-sectional study of the COVID-19 cohort in the Cerner Real-World Dataâ„¢ warehouse, which includes de-identified patient information for encounters associated with COVID-19 from December 1, 2019 through June 30, 2020. The primary variables of interest were medications given to patients during their inpatient COVID-19 treatment. We also collected demographics, calculated the proportion of patients with each medication, and stratified by demographic variables. FINDINGS: Our sample included 51,169 inpatients from every region of the United States. Males and females were equally represented, and the majority of patients were white and non-Hispanic. The largest proportion of patients were older than 45 years old. Steroids had the highest utilization among all patients (56.5%), followed by hydroxychloroquine (17.4%), tocilizumab (3.1%), and lopinavir/ritonavir (1.1%). We found substantial variation in medication utilization by region, race, ethnicity, sex, age and insurance status. IMPLICATIONS: Variations in medication use are likely attributable to multiple factors, including the timing of the pandemic by region in the United States and processes by which medications are introduced and disseminated. This study is the first of its kind to assess trends in medication utilization in a national dataset and is the first large descriptive study of pharmacotherapy in hospitalized COVID-19 patients. It provides an important glimpse into prescribing patterns during a novel pandemic.