Inappropriate prescribing and health outcomes in elderly veteran outpatients.
OBJECTIVE
To determine the relationship of inappropriate prescribing in the elderly to health outcomes.


METHODS
General Medical Clinic of the Durham Veterans Affairs Medical Center.


METHODS
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.


METHODS
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 findings needs to be confirmed in future studies that have larger samples and control for potential confounders.
Schmader
K E
KE
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Hanlon
J T
JT
Landsman
P B
PB
Samsa
G P
GP
Lewis
I K
IK
Weinberger
M
M
D000368:Aged; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D011307:Drug Prescriptions; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008508:Medication Errors; D011446:Prospective Studies; D016896:Treatment Outcome; D014728:Veterans
D000959:Antihypertensive Agents