Medication Safety Events After Acute Myocardial Infarction Among Veterans Treated at VA Versus Non-VA Hospitals

INTRODUCTION: Fragmentation of health care across systems can contribute to mistakes in prescribing and filling medications among patients treated for myocardial infarction (MI). We sought to compare omissions, duplications, and delays in outpatient medications used for secondary prevention among veterans treated for MI at Veterans Affairs (VA) versus non-VA hospitals. METHODS: We utilized national VA and Centers for Medicare and Medicaid Services data (2012-2018) to identify veterans 65 years or older hospitalized for MI and measured the use of outpatient medications for secondary prevention in the 30 days after MI among those treated at VA versus non-VA hospitals. RESULTS: A total of 118,456 veterans experiencing MI were included; of which 102,209 were hospitalized at non-VA hospitals. An omission in any medication class occurred more frequently among veterans treated at non-VA versus VA hospitals (82.8% vs 67.8%, P < 0.001). In multivariable modeling, the odds of omissions in any medication class were higher among those treated at non-VA versus VA hospitals (odds ratio: 3.04; 95% CI: 2.88-3.20). Duplications occurred more frequently in veterans treated at non-VA versus VA hospitals: 1.9% versus 1.6% had 1 or more for non-VA versus VA hospitals ( P < 0.001). Veterans treated at non-VA hospitals were more likely to have delays of 3 days or more in prescription fills after hospital discharge (88.4% vs 70.6% across all classes, P < 0.001). CONCLUSIONS: Omissions, duplications, and delays in outpatient prescribing of secondary prevention medications were more common among 118,456 veterans treated at non-VA versus VA hospitals for MI. Interventions aimed at improving care transitions and optimizing medication use among veterans treated at non-VA hospitals should be implemented

Family medicine · Health care · Logistic regression · Medicaid · Medical prescription · Medication Reconciliation · Myocardial infarction · Odds · Odds ratio · Veterans Affairs · Acute Myocardial Infarction Research · Emergency Medicine · Internal Medicine · Medication Adherence and Compliance · Medicine · Nursing · Pharmaceutical Practices and Patient Outcomes · Pharmacy

• Insights Into Improving Outcomes for Post–Myocardial Infarction Veterans After Hospitalization at Veteran’s Health Administration Versus Non–Veteran’s Health Administration Hospitals

  Kathleen McCauley•Medical Care•2024

  Incluir item

• Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians

  Sunil Kripalani, Frank LeFevre et al.•JAMA•2007

  Incluir item

• Coding Algorithms for Defining Comorbidities in ICD-9-CM and ICD-10 Administrative Data

  Hude Quan, Vijaya Sundararajan et al.•Medical Care•2005

  Incluir item

• Innovations in Community Care Programs, Policies, and Research

  Open Access•Kristin Mattocks, Kristin M Mattocks et al.•Medical Care•2021

  Incluir item