Determinants of Potentially Inappropriate Medication Use among Community-Dwelling Older Adults. - PubMed - NCBI
Health Serv Res. 2016 Sep 29. doi: 10.1111/1475-6773.12562. [Epub ahead of print]
Determinants of Potentially Inappropriate Medication Use among Community-Dwelling Older Adults.
Abstract
OBJECTIVE:
To examine the determinants of potentially inappropriate medication (PIM) use. DATA SOURCES/STUDY SETTING:
U.S. nationally representative data on (n = 16,588) noninstitutionalized older adults (age ≥65) with drug use from the 2006-2010 Medical Expenditure Panel Survey. STUDY DESIGN:
We operationalized the 2012 Beers Criteria to identify PIM use during the year, and we examined associations with individual-level characteristics hypothesized to be quality enabling or related to need complexity. PRINCIPAL FINDINGS:
Almost one-third (30.9 percent) of older adults used a PIM. Multivariate results suggest that poor health status and high-PIM-risk conditions were associated with increased PIM use, while increasing age and educational attainment were associated with lower PIM use. Contrary to expectations, lack of a usual care source of care or supplemental insurance was associated with lower PIM use. Medication intensity appears to be in the pathway between both quality-enabling and need-complexity characteristics and PIM use. CONCLUSION:
Our results suggest that physicians attempt to avoid PIM use in the oldest old but have inadequate focus on the high-PIM-risk conditions. Educational programs targeted to physician practice regarding high-PIM-risk conditions and patient literacy regarding medication use are potential responses. © Health Research and Educational Trust.
KEYWORDS:
Beers Criteria; Potentially inappropriate medications; older adults
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