title: Prevalence and implications of cytochrome P450 substrates in Massachusetts hospital discharges.
abstract: The cytochrome P450 (CYP450) system of drug-metabolizing enzymes may contribute to individual variation in drug response. We examined prevalence of CYP450 substrates at hospital discharge for patients in two cohorts: insurance claims of Massachusetts residents and the medical records of two academic medical centers. The claims cohort included 47 473 individuals (38.2%) treated with at least one CYP450 2D6, 2C19, 3A4 or 1A2 substrate. The electronic medical records cohort included 45 905 individuals (57.4%) treated with at least one substrate. In adjusted models, substrates of CYP450 2D6 and 2C19 were associated with greater risk for 90-day readmission in both cohorts (odds ratios of 1.104 and 1.128 (P<0.001), respectively). Presence of any CYP450 substrate was associated with increased monthly medical costs (+$397, P<0.003). These analyses of more than 300 000 admissions using two different cohorts and data types indicate that CYP450 substrates are associated with greater readmission rates and greater health-care cost.
authors.affiliation: Center for Experimental Drugs and Diagnostics, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: T H
authors.initials: TH
authors.lastname: McCoy
authors.affiliation: Center for Experimental Drugs and Diagnostics, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Partners Research Computing, Partners HealthCare System, One Constitution Center, Boston, MA, USA.|Laboratory of Computer Science and Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: V M
authors.initials: VM
authors.lastname: Castro
authors.affiliation: Center for Experimental Drugs and Diagnostics, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Partners Research Computing, Partners HealthCare System, One Constitution Center, Boston, MA, USA.|Laboratory of Computer Science and Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Cagan
authors.affiliation: Center for Experimental Drugs and Diagnostics, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Roberson
authors.affiliation: Center for Experimental Drugs and Diagnostics, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Perlis
mesh_terms: D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010084:Oxidation-Reduction; D015995:Prevalence
chemical_list: D003577:Cytochrome P-450 Enzyme System