title: Medication acquisition across systems of care and patient-provider communication among older veterans.
abstract: OBJECTIVE
  The results of a survey assessing Medicare Part D enrollment, the use of pharmacotherapies for chronic diseases, and other medication-use issues in a population of elderly military veterans are presented.
  
  
  METHODS
  Medicare-eligible (i.e., ≥65 years of age) patients with documented recent service use at a single Veterans Affairs (VA) medical center were targeted for a mail survey. Women were oversampled (20%) to ensure an adequate sample size; the sample was weighted to adjust for this oversampling. Usable survey data were received from 458 survey respondents.
  
  
  RESULTS
  Nearly all respondents (93.2%) reported having one or more chronic conditions; of those, 93.3% reported regular use of multiple drug therapies, and 30.1% reported using medications prescribed by both VA and non-VA providers for the same chronic condition. About half of the survey respondents reported at least one office visit with a non-VA physician during the previous year, and 55.8% reported obtaining medications from non-VA pharmacies. More than half (54.1%) of the respondents reported non-VA medication coverage, with 21.2% indicating they were enrolled in Medicare Part D. Among the respondents who reported obtaining medications from non-VA pharmacies, substantial proportions reported discussing those medications with VA physicians never (38.4%) or infrequently (15.7%).
  
  
  CONCLUSIONS
  Although large proportions of Medicare-eligible veterans take multiple medications and use non-VA health care services and pharmacies, many do not discuss medications obtained outside the VA system with VA physicians, suggesting that increased efforts to enhance provider-patient communication and medication reconciliation across VA and non-VA systems of care may be warranted.
authors.affiliation: Center for Management of Complex Chronic Care (CMC3), Edward Hines, Jr. VA (Veterans Affairs) Hospital, Hines, IL 60141, USA. kevin.stroupe@va.gov
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hogan
authors.forename: Justin R
authors.initials: JR
authors.lastname: St Andre
authors.forename: Walid F
authors.initials: WF
authors.lastname: Gellad
authors.forename: Saul
authors.initials: S
authors.lastname: Weiner
authors.forename: Todd A
authors.initials: TA
authors.lastname: Lee
authors.forename: Muriel
authors.initials: M
authors.lastname: Burk
authors.forename: Francesca
authors.initials: F
authors.lastname: Cunningham
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.forename: Thea J
authors.initials: TJ
authors.lastname: Rogers
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Huo
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006787:Hospitals, Veterans / Q000592:standards*; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000592:standards*; D008510:Medication Systems, Hospital / Q000592:standards*; D011369:Professional-Patient Relations; D014481:United States; D014728:Veterans