Dual use of VA and Medicare Part D prescription benefits was associated with increased odds of concurrent antihypertensive under- and oversupply (aOR 2.89) compared to VA-only use.
Cohort (n=50,763)
Yes
Does dual use of VA and Medicare Part D drug benefits affect antihypertensive medication supply in older Veterans with dementia?
Obtaining antihypertensives through both VA and Medicare Part D is associated with increased medication under- and oversupply in older Veterans with dementia.
Effect estimate: aOR 2.89 (95% CI 2.53-3.29)
Absolute Event Rate: 10% vs 4%
OBJECTIVE: To evaluate the effect of dual use of VA/Medicare Part D drug benefits on antihypertensive medication supply in older Veterans with dementia. DATA SOURCES/STUDY SETTING: National, linked 2007-2010 Veterans Affairs (VA) and Medicare utilization and prescription records for 50,763 dementia patients with hypertension. STUDY DESIGN: We used inverse probability of treatment (IPT)-weighted multinomial logistic regression to examine the association of dual prescription use with undersupply and oversupply of antihypertensives. DATA COLLECTION/EXTRACTION METHODS: Veterans Affairs and Part D prescription records were used to classify patients as VA-only, Part D-only, or dual VA/Part D users of antihypertensives and summarize their antihypertensive medication supply in 2010: (1) appropriate supply of all prescribed antihypertensive classes, (2) undersupply of ≥1 class with no oversupply of another class, (3) oversupply of ≥1 class with no undersupply, or (4) both undersupply and oversupply. PRINCIPAL FINDINGS: Dual prescription users were more likely than VA-only users to have undersupply only (aOR = 1.28; 95 percent CI = 1.18-1.39), oversupply only (aOR = 2.38; 95 percent CI = 2.15-2.64), and concurrent under- and oversupply (aOR = 2.89; 95 percent CI = 2.53-3.29), versus appropriate supply of all classes. CONCLUSIONS: Obtaining antihypertensives through both VA and Part D was associated with increased antihypertensive under- and oversupply. Efforts to understand how best to coordinate dual-system prescription use are critically needed.
Thorpe et al. (Tue,) conducted a cohort in Dementia with hypertension (n=50,763). Dual use of VA and Medicare Part D drug benefits vs. VA-only drug benefits was evaluated on Concurrent under- and oversupply of antihypertensives versus appropriate supply (aOR 2.89, 95% CI 2.53-3.29). Dual use of VA and Medicare Part D prescription benefits was associated with increased odds of concurrent antihypertensive under- and oversupply (aOR 2.89) compared to VA-only use.