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Potentially inappropriate medication use by elderly persons in U.S. health maintenance organizations, 2000-2001.

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Title: Potentially inappropriate medication use by elderly persons in U.S. health maintenance organizations, 2000-2001.
Authors: Simon SR (AUTHOR), Chan KA (AUTHOR), Soumerai SB (AUTHOR), Wagner AK (AUTHOR), Andrade SE (AUTHOR), Feldstein AC (AUTHOR), Lafata JE (AUTHOR), Davis RL (AUTHOR), Gurwitz JH (AUTHOR)
Source: Journal of the American Geriatrics Society. Feb2005, Vol. 53 Issue 2, p227-232. 6p.
Abstract: OBJECTIVES: To determine rates of potentially inappropriate medication use in elderly persons in managed care plans in the United States in 2000-2001. DESIGN: Cross-sectional study using automated medication-dispensing data. SETTING: Ten geographically distributed health maintenance organizations (HMOs). PARTICIPANTS: One hundred fifty-seven thousand five hundred seventeen members aged 65 years and older enrolled in one of the HMOs. MEASUREMENTS: Prevalence of use of 33 potentially inappropriate medications from January 1, 2000 through June 30, 2001. RESULTS: In 2000-2001, 28.8% (95% confidence interval=28.6-29.1) of elderly individuals received at least one of 33 potentially inappropriate medications. This rate ranged from 23.0% to 36.5% across the 10 HMOs. Approximately 5% of elderly patients received at least one of the 11 medications classified by an expert panel as 'always avoid,' 13% received at least one of the eight medications that would rarely be considered appropriate, and 17% received at least one of the 14 medications that have some indications but are often misused. Overall, rates of use of these medications were greater in women (32.4%) than in men (24.2%). At least 1% of elderly members received belladonna alkaloids (2.3%), dicyclomine (1.1%), or hyoscyamine (1.2%), each of which multiple expert panels have classified as always inappropriate in patients aged 65 years and older. Seven percent of elderly members received propoxyphene, an analgesic medication considered rarely appropriate in the elderly and a drug that has a long history of limited efficacy and potential for toxicity. CONCLUSION: Recent rates of potentially inappropriate medication use by elderly HMO members were at least as great as in a 1996 national sample. This study highlights the need to understand more fully the rationale behind the continued use of these medications. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Potentially inappropriate medication use by elderly persons in U.S. health maintenance organizations, 2000-2001.
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  Data: <searchLink fieldCode="AR" term="%22Simon+SR%22">Simon SR</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chan+KA%22">Chan KA</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Soumerai+SB%22">Soumerai SB</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wagner+AK%22">Wagner AK</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Andrade+SE%22">Andrade SE</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Feldstein+AC%22">Feldstein AC</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lafata+JE%22">Lafata JE</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Davis+RL%22">Davis RL</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gurwitz+JH%22">Gurwitz JH</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Geriatrics+Society%22">Journal of the American Geriatrics Society</searchLink>. Feb2005, Vol. 53 Issue 2, p227-232. 6p.
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: OBJECTIVES: To determine rates of potentially inappropriate medication use in elderly persons in managed care plans in the United States in 2000-2001. DESIGN: Cross-sectional study using automated medication-dispensing data. SETTING: Ten geographically distributed health maintenance organizations (HMOs). PARTICIPANTS: One hundred fifty-seven thousand five hundred seventeen members aged 65 years and older enrolled in one of the HMOs. MEASUREMENTS: Prevalence of use of 33 potentially inappropriate medications from January 1, 2000 through June 30, 2001. RESULTS: In 2000-2001, 28.8% (95% confidence interval=28.6-29.1) of elderly individuals received at least one of 33 potentially inappropriate medications. This rate ranged from 23.0% to 36.5% across the 10 HMOs. Approximately 5% of elderly patients received at least one of the 11 medications classified by an expert panel as 'always avoid,' 13% received at least one of the eight medications that would rarely be considered appropriate, and 17% received at least one of the 14 medications that have some indications but are often misused. Overall, rates of use of these medications were greater in women (32.4%) than in men (24.2%). At least 1% of elderly members received belladonna alkaloids (2.3%), dicyclomine (1.1%), or hyoscyamine (1.2%), each of which multiple expert panels have classified as always inappropriate in patients aged 65 years and older. Seven percent of elderly members received propoxyphene, an analgesic medication considered rarely appropriate in the elderly and a drug that has a long history of limited efficacy and potential for toxicity. CONCLUSION: Recent rates of potentially inappropriate medication use by elderly HMO members were at least as great as in a 1996 national sample. This study highlights the need to understand more fully the rationale behind the continued use of these medications. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Feb2005
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