PT-005 - MAJOR POTENTIAL DRUG-DRUG INTERACTIONS AMONG MEDICAID-INSURED CHILDREN IN THE OUTPATIENT SETTING.

K. Kyler¹, M. Hall², J. Antoon³, J. Goldman¹, S. Shah⁴, S. Tang Girdwood⁴, D. Williams³, J. Feinstein⁵; ¹Children's Mercy Kansas City, Kansas City, MO, USA, ²Children's Hospital Association, Lenexa, KS, USA, ³Vanderbilt University Medical Center, Nashville, TN, USA, ⁴Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA, ⁵Children's Hospital of Colorado, Denver, CO, USA.

Background: Drug-drug interactions can cause adverse drug events (ADEs). We aimed to determine potential drug-drug interaction (pDDI) prevalence and factors associated with higher pDDI rates among Medicaid-enrolled children.

Methods: We performed a cross-sectional study using the 2019 Marketscan Medicaid database. Children aged 0-18 years who had ≥1 ambulatory encounter and ≥2 dispensed outpatient prescriptions were included. Major pDDIs and the physiologic end effects of each pDDI were identified using DrugBank’s interaction database. Major pDDI prevalence was summarized using percentages. We used logistic regression to assess for factors associated with pDDI exposure.

Results: Of 781,019 included children, 21.4% experienced ≥1 major pDDI. Drugs frequently implicated in major pDDIs included: clonidine, psychiatric drugs (e.g., antipsychotics, antidepressants), and asthma drugs. Frequent physiologic end-effects for common major pDDIs included CNS depression, QTc prolongation, and increased serum drug levels. The odds of major pDDI exposure increased with age and with medical and mental health complexity (Fig 1).

Conclusion: Major pDDIs occurred in 1 out of every 5 Medicaid-insured children. Exposure to pDDIs increases the risk of ADEs, especially in the less supervised and harder to monitor outpatient setting.

Figure 1. Adjusted odds* of having any major pDDI