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Prescribing quality in older veterans: a multifocal approach.
Michael A Steinman1, Yinghui Miao, W John Boscardin
1Division of Geriatrics, University of California, San Francisco, 4150 Clement St, VA Box 181G, San Francisco, CA, 94141, USA, Mike.steinman@ucsf.edu.
Journal of General Internal Medicine
|July 9, 2014
Summary
Prescribing problems affect half of older veterans, with medication number being the strongest risk factor. Targeting patients with multiple medications is key to improving prescribing quality.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Health Services Research
Background:
- Quality prescribing for older adults is complex.
- Older adults are at higher risk for adverse drug events.
- Understanding prescribing problems in this population is crucial.
Purpose of the Study:
- To evaluate prescribing quality in older veterans.
- To identify common prescribing problems.
- To analyze how these problems vary across subgroups.
Main Methods:
- Cross-sectional observational study of veterans aged 65+.
- Utilized Department of Veterans Affairs (VA) pharmacy data linked with other health records.
- Assessed five types of prescribing problems.
Main Results:
- 50% of older veterans experienced at least one prescribing problem.
- High medication burden significantly increased risk for all prescribing problems.
- Age was not a strong predictor, but comorbidity increased risk for specific issues.
Conclusions:
- The number of medications is the primary risk factor for prescribing problems in older adults.
- Interventions should focus on patients with polypharmacy.
- Improving prescribing quality requires addressing medication burden.
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