ConceptSet

Paxlovid, Drug Exposure


Variable Name

rx_paxlovid

Refreshed Date

2022-10

Files

2 Downloads↓
rx_2022_10_Paxlovid_V1.csv (6.96 KB)
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FIND_PAXLOVID_FUNCTION.R (4.69 KB)
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Tags

Level of Review

Data Model

Vocabularies



The concept set was intended to identify all patients with a drug_exposure record indicating a Paxlovid exposure (nirmatrelvir/ritonavir).


Variable Status

Funder(s)

Provenance

This concept set was originally developed to extract COVID patients out of the PEDSnet CDM observation table for the the Researching COVID to Enhance Recovery (RECOVER) Post-Acute Sequelae of SARS-CoV-2 (PASC) Electronic Health Record (EHR) Cohort Study. RECOVER was a was a long-term NIH-funded project focused on analyzing the COVID-19 outbreak, especially the long term health impacts of the pandemic. Thid codeset has also been used in a RECOVER Y1, Q3 query and used to define a cohort in the "COVID and Diabetes Assessment Study (CODA)". These concepts were later reviewed and refined for a brief report on pediatric nirmatrelvir and ritonavir prescribing patterns, "Pediatric Nirmatrelvir/Ritonavir Prescribing Patterns During the COVID-19 Pandemic" (Bose-Brill et. al., 2022).

Description

One of several codesets in the PEDSnet observation_derivation_recover(ODR) workflow to extract COVID-19 patients from the PEDSnet CDM observation table. This concept set was used to identify pediatric patients under 18 who were prescribed Paxlovid.

The concept set was developed by identifying RxNorm codes at the SCDF/SCDG level and descendants indicating Paxlovid, then string searching for the terms ‘paxlovid’, ‘ritonavir’, and ‘nirmatrelvir’ in ‘concept_name’. Codes were identified in the ‘code_type’ column as ‘Paxlovid’ (indicating nirmatrelvir/ritonavir), ‘nirmatrelvir’ (indicating nirmatrelvir alone) and ‘ritonavir’ (indicating ritonavir alone).

Please note, this concept set should not be used without appropriate accompanying logic to identify Paxlovid; the concept set contains individual ingredients that comprise the combination. Ritonavir and nirmatrelvir exposure must occur together on the same date to indicate a combination drug prescription. The attached file, FIND_PAXLOVID_FUNCITON.R, provides logic showing how the concept set can be used.

Medication Term Classes



Clinical Subjects Headings

Development Code

Study Variable Applications

The Researching COVID to Enhance Recovery (RECOVER) Post-Acute Sequelae of SARS-CoV-2 (PASC) Electronic Health Record (EHR) Cohort Study
Study Dates:2021-10 - 2026-05Sponsor Site:PEDSnet Data Coordinating Center
Study to understand, prevent, and treat post-acute sequelae of SARS-CoV-2 (PASC), including Long COVID.
#### [View the RECOVER initiative website here.](https://recovercovid.org/)
The COvid and Diabetes Assessment (CODA) Study
Study Dates:2023 - PresentSponsor Site:Children's Hospital of Philadelphia
Study to rapidly identify, recruit, and retain diverse cohorts of English and Spanish speaking pediatric and adult patients with recently diagnosed type one or type two diabetes (T1D or T2D) to examine the relationship between SARS-CoV-2 and COVID-19 infection and diabetes.

Published Research Applications

Pediatric Nirmatrelvir/Ritonavir Prescribing Patterns During the COVID-19 Pandemic
Published:2024-08-01Journal:Hospital Pediatrics
**Objectives:** This study seeks to identify demographic and clinical factors prompting clinician prescribing of nirmatrelvir/ritonavir to pediatric patients for management of coronavirus disease 2019 (COVID-19) infection. **Methods:** Patients aged 12 to 17 years with a COVID-19 infection and nirmatrelvir/ritonavir prescription during an outpatient clinical encounter within a PEDSnet-affiliated institution between January 2022 and August 2023 were identified using electronic health record data. A multivariate logistic regression analysis was used to estimate odds of nirmatrelvir/ritonavir prescription after adjusting for various factors. **Results:** A total of 20 959 patients aged 12 to 17 years were diagnosed with a COVID-19 infection on the basis of an electronic health record-documented positive polymerase chain reaction or antigen test or diagnosis during an outpatient clinical visit. Of these patients, 408 received a nirmatrelvir/ritonavir prescription within 5 days of diagnosis. Higher odds of nirmatrelvir/ritonavir treatment were associated with having chronic or complex chronic disease (chronic: odds ratio [OR] 2.50 [95% confidence interval (CI) 1.83-3.38]; complex chronic: OR 2.21 [95% CI 1.58-3.08]). Among patients with chronic disease, each additional body system conferred 1.18 times higher odds of treatment (95% CI 1.10-1.26). Compared with non-Hispanic white patients, Hispanic patients (OR 0.61 [95% CI 0.44-0.83]) had lower odds of treatment. **Conclusions:** Children with chronic conditions are more likely than those without to receive nirmatrelvir/ritonavir prescriptions. However, nirmatrelvir/ritonavir prescribing to children with chronic conditions remains infrequent. Pediatric data concerning nirmatrelvir/ritonavir safety and effectiveness in preventing severe disease and hospitalization are critical optimizing clinical decision-making and use among children.

Data Source

Related Phenotype

Related Person

Related Concept Set

Related Code

Observation Derivation RECOVER
Created:2022
Code to pull PASC/COVID-relevant observations from the CDM and metadata to describe the resulting tables.

Creative Commons license

a CC-BY Attribution 4.0 License.
Except where otherwised noted, this item's license is described as a CC-BY Attribution 4.0 License.