Trazodone HCL is associated with Lower Hospital Readmission Rates for Psychoses Patients at Chippenham Hospital based on Real World Evidence Study of Medicare Claims Data

---

In Trazodone, Psychoses

By: Sara Riascos  Apr. 21, 2022

Background:

Psychosis is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Trazodone HCL is a tetracyclic antidepressant used to treat depression and anxiety disorders. Studies have shown that Trazodone is appreciated worldwide because of its clinical effectiveness in controlling a wide range of symptoms of psychosis, and for the absence of negative effects on sleep.

Dexur’s analysis of Real World Evidence based on Medicare Claims data showed that the use of Trazodone HCL within 7 days of hospitalization was associated with lower hospital readmission rates for Psychoses Patients at Chippenham Hospital in Richmond, Virginia. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real World Evidence from Medicare Claims data, for hospitalizations at Chippenham Hospital between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Psychoses related codes (Listed in table below)
2. Stratified Selected population into cohorts
   1. Psychoses patients who dispensed Trazodone HCL within 7 Days of Hospitalization using Part D drugs claims database
   2. Psychoses patients who did not dispense Trazodone HCL within 7 Days of Hospitalization
3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Trazodone HCL was associated with lower hospital readmission rates for all Primary DRG Diagnosis Codes examined at Chippenham Hospital . For patients whose primary DRG Diagnosis was “Psychoses”(885) and when Trazodone HCL was used within 7 days of hospitalization, the readmission rate was 22.45% compared to the cohort where Trazodone HCL was not used, whose readmission rate was 28.77%. The readmission odds ratio for these cohorts was 0.72. The use of Trazodone HCL was associated with a 28% lower readmission rate when used within 7 days of hospitalization. The full list of studied DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Trazodone HCL at Chippenham Hospital is shown below.

Primary DRG Diagnosis Code	Primary DRG Diagnosis Code Description	Total Hospitalizations without Trazodone HCL	Readmission Without Trazodone HCL	Readmission Rate without Trazodone HCL	Total Hospitalizations with Trazodone HCL	Readmission with Trazodone HCL	Readmission Rate with Trazodone HCL	Readmission Odds Ratio	Reduction in Readmission with Trazodone HCL (%)	Confidence Interval (-)	Confidence Intervals (+)
885	Psychoses	2,196

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Psychoses were not prescribed Trazodone HCL within 7 days of discharge.

DRG CODE	Hospital	Hospitalizations with Psychoses	% of Hospitalizations without Trazodone HCL
885	Southcoast Behavioral Health Hospital - Dartmouth	3,195	99.66%
	Chippenham Hospital	2,207	99.50%
	Memorial Hospital of Tampa	1,598	99.31%

​Hospitalizations with Psychoses = Above Listed DRG Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real World Evidence of Medicare Claims data, for hospitalizations between January 2017 to September 2019, the use of Trazodone HCL within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Psychoses patients at Chippenham Hospital. This analysis shows that a significant number of Patients are not dispensed Trazodone HCL after Psychoses hospitalizations at Chippenham Hospital or major US Hospitals.