Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration?

Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? Research Abstract Details 

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Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? Abstract Text:

OBJECTIVES: To identify the extent of inappropriate prescribing using criteria for proper use developed by the Agency for Healthcare Research and Quality (AHRQ) and dose-limitation criteria defined by Beers, as well as to describe duration of use and patient characteristics associated with inappropriate prescribing for older people. DESIGN: Retrospective national Veterans Health Administration (VA) administrative database analysis. SETTING: VA outpatient facilities during fiscal year 2000 (FY00). Participants: Veterans aged 65 and older having at least one VA outpatient visit in FY00 (N=1,265,434). MEASUREMENTS: Operational definitions of appropriate use were developed based on recommendations of an expert panel convened by the AHRQ (Zhan criteria). Inappropriate use was identified based on these criteria and inappropriate use of drugs per Beers criteria for dose-limitations in older people. Furthermore, duration of use and patient characteristics associated with inappropriate use were described. RESULTS: After adjusting for diagnoses, dose, and duration, inappropriate prescribing decreased from 33% to 23%. Exposure to inappropriate drugs was prolonged. Pain relievers, benzodiazepines, antidepressants, and musculoskeletal agents constituted 61% of inappropriate prescribing. Whites, patients with psychiatric comorbidities, and patients receiving more medications were most likely to receive inappropriate drugs. Women were more likely to receive Zhan criteria drugs; men were more likely to receive dose-limited drugs CONCLUSION: For the most part, the Zhan criteria did not explain inappropriate prescribing, which includes problems related to dose and duration of prescriptions. Interventions targeted at prescriptions for pain relievers, benzodiazepines, antidepressants, and musculoskeletal agents may dramatically decrease inappropriate prescribing and improve patient outcomes.

Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? Publishing Authors By Initials

For similar persons: veterans research abstracts see: persons: veterans research

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Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Journal of the American Geriatrics Society

VOLUME: 53

Page Numbers: 1282-9

Journal Abbreviation: J Am Geriatr Soc

ISSN: 0002-8614

DAY: 10

MONTH: Aug

YEAR: 2005

Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? Information

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LANGUAGE: eng

NlmUniqueID: 7503062

Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? Keywords Mesh Terms:

KEYWORDS: Veterans

MESH TERMS: standards

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AFFILIATION: Veterans Evidence-based Research Dissemination and Implementation Center, Audie L. Murphy Division /South Texas Veterans Health Care System, San Antonio, Texas 78229, USA. pughm@uthscsa.edu

Country: United States

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MEDLINETA: J Am Geriatr Soc

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