Inappropriate Prescribing and Health Outcomes in Elderly Veteran Outpatients

Annals of Pharmacotherapy - Tập 31 Số 5 - Trang 529-533 - 1997
Kenneth E. Schmader1, Joseph T. Hanlon2, Pamela B. Landsman3, Greg Samsa4, Ingrid K. Lewis5, Morris Weinberger6
1Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
2University of North Carolina
3VA Medical Center
4Duke University; VA Medical Center
5University of North Carolina; VA Medical Center
6Health Policy and Management

Tóm tắt

OBJECTIVE: To determine the relationship of inappropriate prescribing in the elderly to health outcomes. SETTING: General Medical Clinic of the Durham Veterans Affairs Medical Center. PATIENTS: A total of 208 veterans more than 65 years old who were each taking five or more drugs and participated in a pharmacist intervention trial. MEASUREMENTS: Prescribing appropriateness was assessed by a clinical pharmacist using the medication appropriateness index (MAI). A summed MAI score was calculated, with higher scores indicating less appropriate prescribing. The health outcomes were hospitalization, unscheduled ambulatory or emergency care visits, and blood pressure control. RESULTS: Bivariate analyses revealed that mean MAI scores at baseline were higher for those with hospital admissions (18.9 vs. 16.9, p = 0.07) and unscheduled ambulatory or emergency care visits (18.8 vs. 16.3, p = 0.05) over the subsequent 12 months than for those without admissions and emergency care visits. MAI scores for antihypertensive medications were higher for patients with inadequate blood pressure control (> 160/90 mm Hg) than for those whose blood pressure was controlled (4.7 vs. 3.1, p = 0.02). CONCLUSIONS: Inappropriate prescribing appeared to be associated with adverse health outcomes. This finding needs to be confirmed in future studies that have larger samples and control for potential confounders.

Từ khóa


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Annals of Pharmacotherapy

Tập 31 Số 5

529-533

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