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Exposure to potentially harmful drug-disease interactions in older community-dwelling veterans based on the Healthcare Effectiveness Data and Information Set quality measure: who is at risk?
- Source :
-
Journal of the American Geriatrics Society [J Am Geriatr Soc] 2011 Sep; Vol. 59 (9), pp. 1673-8. Date of Electronic Publication: 2011 Aug 10. - Publication Year :
- 2011
-
Abstract
- Objectives: To identify prevalence and risk factors for exposure to drug-disease interactions included in the Healthcare Effectiveness Data and Information Set (HEDIS) Drug-Disease Interaction (Rx-DIS) measure.<br />Design: Cross-sectional retrospective database analysis.<br />Setting: Outpatient clinics within the Department of Veterans Affairs (VA).<br />Participants: Individuals aged 65 and older who received VA outpatient care between October 1, 2003, and September 30, 2006.<br />Measurements: Rx-DIS exposure based on the HEDIS measure was identified in VA patients with dementia, falls, and chronic renal failure using VA pharmacy and administrative databases. Factors associated with Rx-DIS exposure were examined, including demographic, health status, and access-to-care factors, including VA outpatient health services use and copayment status.<br />Results: Of the 305,041 older veterans who met criteria for inclusion, the 1-year prevalence of Rx-DIS exposure was 15.2%; prevalence was 20.2% for dementia, 16.2% for falls, and 8.5% for chronic renal failure. Patients with high disease burden (physical, psychiatric, number of medications) were significantly more likely to have Rx-DIS exposure, regardless of condition. Hispanics and individuals with no copayments were more likely to have Rx-DIS exposure than whites or those with required copayments. There was variation in other predictors based on the type of Rx-DIS.<br />Conclusion: The prevalence of Rx-DIS was common in older VA outpatients. Future studies should examine the risk of Rx-DIS exposure on health outcomes using separate analyses for each type of Rx-DIS separately before combining all Rx-DIS into a single measure of exposure. Studies that examine the effectiveness of interventions to reduce Rx-DIS exposure will also be helpful in improving the quality of care for older adults.<br /> (© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.)
- Subjects :
- Aged
Aged, 80 and over
Cross-Sectional Studies
Databases, Factual
Female
Humans
Male
Prevalence
Risk Factors
United States
United States Department of Veterans Affairs
Veterans
Accidental Falls statistics & numerical data
Ambulatory Care statistics & numerical data
Dementia epidemiology
Inappropriate Prescribing statistics & numerical data
Kidney Failure, Chronic epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-5415
- Volume :
- 59
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 21831166
- Full Text :
- https://doi.org/10.1111/j.1532-5415.2011.03524.x