Pharmacy Practice Faculty Publications
Patterns of Potentially Inappropriate Medication Use Across Three Cohorts of Older Medicaid Recipients
Document Type
Article
Publication Date
7-2005
Journal Title
Annals of Pharmacotherapy
ISSN
1060-0280
Volume
39
Issue
7-8
First Page
1175
Last Page
1181
DOI
http://dx.doi.org/10.1345/aph.1e581
PubMed ID
15928259
Abstract
BACKGROUND Potentially inappropriate medication use is a serious quality concern, especially when it occurs in more vulnerable older adults or for extended durations.
OBJECTIVE To characterize patterns of inappropriate medication use and duration among 3 cohorts with differing health status.
METHODS We identified unconditionally inappropriate drug use, using Beers 1997 criteria, among 3185 older Kansas Medicaid beneficiaries. Claims from May 2000 to April 2001 provided data for 3 cohorts: nursing facility (NF) residents, recipients of home- and community-based services through the Frail Elderly (FE) program, and persons with neither NF/FE care (Ambulatory). Duration, categorized as short-term (≤1 month's supply), extended (>1–9 mo), or chronic (>9–12 mo), was determined for each drug and cohort. Drug–disease associations were explored.
RESULTS Any inappropriate medication use occurred in 21%, 48%, and 38% of Ambulatory, FE, and NF cohorts, respectively. Inappropriate analgesics, antihistamines, antidepressants, muscle relaxants, and oxybutynin were most common, but prevalence and duration varied by cohort. Short-term analgesic and antihistamine use was common. FE cohort members had the highest use rates for all drugs. The NF cohort had less antidepressant and muscle relaxant use. Drug–disease associations were noted for amitriptyline use in diabetes mellitus, propoxyphene use in musculoskeletal and upper gastrointestinal conditions, and muscle relaxant use in musculoskeletal conditions.
CONCLUSIONS Cross-sectional, one-year prevalence figures are comprised of both short- and long-term use that varies by drug and cohort. NF residence is associated with reduced use of drugs scrutinized during mandated medication review. Relevant diseases are associated with specific inappropriate prescribing. Future efforts should target extended and chronic duration of use and persons at highest risk for adverse effects, including recipients of home- and community-based care.
Keywords
Geriatrics, Medicaid, prescribing patterns, medication, pharmacotherapy
Recommended Citation
Rigler, Sally K.; Jachna, Carolyn M.; Perera, Subashan; Shireman, Theresa I.; and Eng, Marty L., "Patterns of Potentially Inappropriate Medication Use Across Three Cohorts of Older Medicaid Recipients" (2005). Pharmacy Practice Faculty Publications. 84.
https://digitalcommons.cedarville.edu/pharmacy_practice_publications/84