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Health Serv Res. 2017 Aug;52(4):1534-1549. doi: 10.1111/1475-6773.12562. Epub 2016 Sep 29.

Determinants of Potentially Inappropriate Medication Use among Community-Dwelling Older Adults.

Author information

1
Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD.
2
Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.
3
Department of Health Policy and Management, Gillings School of Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC.
4
Department of Geriatric Pharmacotherapy, Pharmacy Practice and Science, University of Maryland, Baltimore School of Pharmacy, Baltimore, MD.
5
Peter Lamy Center on Drug Therapy and Aging, Baltimore, MD.
6
College of Nursing, Pennsylvania State University, University Park, PA.

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.

KEYWORDS:

Beers Criteria; Potentially inappropriate medications; older adults

PMID:
27686781
PMCID:
PMC5517671
DOI:
10.1111/1475-6773.12562
[Indexed for MEDLINE]
Free PMC Article

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