Population-wide prescription trajectories, polypharmacy and drug-drug interactions

Abstract

¨Multi-step disease and prescription trajectories are key to the understanding of human disease progression patterns and their underlying molecular level etiologies. We present approaches to the identification of frequent prescription trajectories from population-wide healthcare data comprising millions of patients and corresponding strategies for linking these to observed changes in drug dosages in poly-pharmacy settings. Patterns and observations are further linked to known and possibly currently unknown drug-drug interactions. This type of analysis can form the basis for creating N=1 treatment plans. Examples on how changes in drug use correlate with mortality will be presented. We use prescription and diagnosis data covering 7-10 million patients from Denmark collected over a 25–40-year period and use them to “condense” millions of individual trajectories into a smaller set of recurrent ones.”