Abstract
Background: Certain medications can have a negative impact on health during heatwaves. This can be caused through a variety of mechanisms triggered by heat, including insufficient body heat regulation, changes in cardiac or renal function or pharmacokinetic changes. The objective of the ADAPT-Heat project (Adaptation of drug therapy during hot seasons, funded by the German Innovation Fund) is to co-design evidence-based recommendations for heat-sensitive medication adjustments to prevent adverse events. These recommendations are to be applied in primary, secondary and social care, as well as municipal settings.
Approach: The project’s first step was a systematic literature review to identify all potentially inadequate medications during heat (heat-PIM). In order to supplement this list with more detailed information, an analysis of claims data of a large German statutory health insurance company (BARMER, 8.7 mio insurants) is being carried out. For each heat-PIM from the literature review, we examine the frequency and average quantity (DDD, defined daily dose) of prescription, the specialization of the prescribing doctors, and the co-morbidities and co-medications of the patients. Results from this are fed back into a co-design activity to develop recommendations for care professionals, municipalities and citizens, involving representatives of all these groups.
Results: The literature research yielded a list of ~50 medications, defined by their ATC code (Anatomical Therapeutic Chemical Classification System). These ATC codes are currently being used in the claims data analysis. We will present its results, further research steps and the implications for the development of the recommendations at ICIC25.
Implications: On the one hand, the results can help to prioritize the heat-PIM and highlight those which have a high prescription frequency. This is considered necessary due to the large number of heat-PIM identified from literature. The claims data results will also inform the next work step in the project, namely an analysis of actual health impacts of selected medications during past heatwaves. Finally, the results will be used to determine the target group for recommendations more precisely and to adapt these recommendations to the different target groups.