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Potentially Inappropriate Medication Use Among Patients With Dementia in Traditional Medicare and Medicare Advantage

Bibliographic Data

ID9103585
AuthorsEli Raver (0000-0002-6904-770X, The Ohio State University, corresponding author), Jeah Jung (0000-0001-7574-0677, George Mason University), Caroline Carlin (0000-0003-0813-3433, University of Minnesota), Roger Feldman (University of Minnesota), Sheldon M Retchin (0000-0003-3816-3529, The Ohio State University), Wendy Xu (0000-0002-7142-6784, The Ohio State University)
Year2025
Volume63
Issue7
Pages495-499
Publication date2025-07-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002160
PMID40766987
OpenAlexW4410551447
LanguageEN
References cited23

BACKGROUND: Older adults with dementia are susceptible to receiving potentially inappropriate medications (PIMs), where the risks likely outweigh the benefits. Medicare advantage prescription drug plans (MA-PDs) cover both medical and prescription drug benefits, creating a financial incentive to reduce PIM use and unnecessary health care costs from adverse drug events, whereas standalone Medicare prescription drug plans (PDPs) used by traditional Medicare beneficiaries are only responsible for outpatient prescription drug costs. OBJECTIVE: The objective is to compare the use of PIMs between PDP and MA-PD enrollees with dementia. METHODS: Using 2016-2019 Medicare claims and encounter data, we estimated the associations between Medicare enrollment type and PIM use: (1) potentially harmful drug-disease interactions in older adults with dementia; (2) potentially harmful drug-disease interactions in older adults with dementia and a history of falls; and (3) high-risk medication use in older adults. RESULTS: MA-PD enrollees had significantly lower utilization of PIMs than standalone PDP enrollees: a 0.7 percentage-point [95% CI: 0.5, 0.8] lower prevalence of potentially harmful drug-disease interactions in older adults with dementia; a 3.1 percentage-point [2.6, 3.5] lower prevalence of potentially harmful drug-disease interactions in older adults with dementia and a history of falls; and a 0.5 percentage-point [0.4, 0.6] lower prevalence of high-risk medications in older adults. CONCLUSIONS: MA-PD enrollees with dementia experienced consistently lower prevalence of PIM use than those in PDP. As Medicare advantage enrollment continues to grow, it will be increasingly important to identify and leverage the features of MA-PD plans that promote safe medication prescribing for Medicare beneficiaries with dementia

Dementia · Disease · Health care · Intensive care medicine · Medical prescription · Medicare Advantage · Medicare Part D · Medication adherence · MEDLINE · Prescription drug · Chronic Disease Management Strategies · Internal Medicine · Medication Adherence and Compliance · Medicine · Nursing · Pharmaceutical Practices and Patient Outcomes

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Citation velocityhistorical
Highly citedNo
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