Determinants of Potentially Inappropriate Medication Use among Community-Dwelling Older Adults.
To examine the determinants of potentially inappropriate medication (PIM) use.



U.S. nationally representative data on (n = 16,588) noninstitutionalized older adults (age ≥65) with drug use from the 2006-2010 Medical Expenditure Panel Survey.



We operationalized the 2012 Beers Criteria to identify PIM use during the year, and we examined associations with individual-level characteristics hypothesized to be quality enabling or related to need complexity.



Almost one-third (30.9 percent) of older adults used a PIM. Multivariate results suggest that poor health status and high-PIM-risk conditions were associated with increased PIM use, while increasing age and educational attainment were associated with lower PIM use. Contrary to expectations, lack of a usual care source of care or supplemental insurance was associated with lower PIM use. Medication intensity appears to be in the pathway between both quality-enabling and need-complexity characteristics and PIM use.



Our results suggest that physicians attempt to avoid PIM use in the oldest old but have inadequate focus on the high-PIM-risk conditions. Educational programs targeted to physician practice regarding high-PIM-risk conditions and patient literacy regarding medication use are potential responses.
Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD.
G Edward
GE
Miller
Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD.
Eric M
EM
Sarpong
Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.
Amy J
AJ
Davidoff
Department of Health Policy and Management, Gillings School of Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC.
Eunice Y
EY
Yang
Department of Geriatric Pharmacotherapy, Pharmacy Practice and Science, University of Maryland, Baltimore School of Pharmacy, Baltimore, MD.|Peter Lamy Center on Drug Therapy and Aging, Baltimore, MD.
Nicole J
NJ
Brandt
College of Nursing, Pennsylvania State University, University Park, PA.
Donna M
DM
Fick
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008508:Medication Errors; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List; D036301:Qualitative Research; D012307:Risk Factors; D014481:United States
Beers Criteria; Potentially inappropriate medications; older adults
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