Racial and Ethnic Differences in Potentially Inappropriate Medication Use Among Medicare Beneficiaries.

Area of Science:

• Geriatric Medicine
• Health Services Research
• Pharmacoeconomics

Background:

• Older adults are susceptible to potentially inappropriate medications (PIMs), where risks exceed benefits.
• Racial and ethnic disparities in PIM use can exacerbate health inequities and lead to adverse drug events.

Purpose of the Study:

• To investigate the association between race/ethnicity and PIM use in older Medicare beneficiaries.
• To identify potential disparities in high-risk medication use and harmful drug-disease interactions.

Main Methods:

• Cross-sectional study utilizing nationwide Medicare Part D, fee-for-service claims, and Medicare Advantage (MA) data (2016-2019).
• Analysis included a large sample of Medicare beneficiaries aged 65 years and older.
• Linear probability models assessed high-risk medication use and harmful drug-disease interactions in patients with dementia or a history of falls.

Main Results:

• White beneficiaries exhibited higher rates of high-risk medication use compared to Asian/Pacific Islander, Black, and Hispanic beneficiaries.
• White beneficiaries also had the highest rates of potentially harmful drug-disease interactions in patients with dementia and a history of falls.
• Observed racial and ethnic differences in PIM use were smaller in MA plans compared to traditional Medicare (TM) plans.

Conclusions:

• White Medicare beneficiaries consistently showed higher rates of PIM use than other racial and ethnic groups.
• These disparities may be partly explained by differences in overall prescription drug utilization.
• Reducing PIM use across all racial and ethnic groups is crucial for mitigating health disparities.