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J Am Geriatr Soc. 2011 Sep;59(9):1673-8. doi: 10.1111/j.1532-5415.2011.03524.x. Epub 2011 Aug 10.

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?

Author information

  • 1Veterans Evidence-based Research and Implementation CenterGeriatrics and Extended Care, South Texas Veterans Health Care System, San Antonio, Texas 78229, USA. pughm@uthscsa.edu

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.

DESIGN:

Cross-sectional retrospective database analysis.

SETTING:

Outpatient clinics within the Department of Veterans Affairs (VA).

PARTICIPANTS:

Individuals aged 65 and older who received VA outpatient care between October 1, 2003, and September 30, 2006.

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.

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.

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.

© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

PMID:
21831166
[PubMed - indexed for MEDLINE]
PMCID:
PMC3390785
Free PMC Article
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