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Medication Management in the Elderly

These HEDIS Measures

Potentially Harmful Drug-Disease Interactions in the Elderly: Assesses adults 65 and older who have a specific disease or condition (chronic renal failure, dementia, history of falls) and were dispensed a prescription for a medication that could exacerbate it. 

Use of High-Risk Medications in the Elderly: Assesses adults 65 and older who had at least one dispensing event for a high-risk medication or who had at least two dispensing events for the same high-risk medication.

The Bottom Line

Prescription drug use by the elderly can often result in adverse drug events that contribute to hospitalization, increased duration of illness, nursing home placement, falls and fractures. Despite widely accepted medical consensus that certain drugs increase the risk of harm to the elderly,1 these drugs continue to be prescribed. Because older adults are more likely to take multiple medications for multiple conditions, they are also at higher risk of potentially harmful drug-disease interactions. Avoiding the use of high-risk drugs is an important, simple and effective strategy to reduce medication-related problems and adverse drug events in older adults.2 

References

    1. Fick, D.M., et al.2003. “Updating the Beers criteria for potentially inappropriate medication use in older adults.” Arch Intern Med 163:2716–24.
    2. Radcliff, S., Yue, J., Rocco, G., Aiello, S.E., Ickowicz, E., Hurd, Z., Samuel, M.J. and Beers, M.H. 2015. “American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults.” Journal of the American Geriatrics Society, 63(11): 2227-2246.
tables
Potentially Inappropriate Medications for Patients With Chronic Renal Failure*
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016 --  -- -- 10.7 7.4
2015 10.4 7.6
2014 10.3 7.9
2013 11.1 8.9
*Lower rates signify better performance.
Potentially Inappropriate Medications for Patients With Dementia*
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016 -- -- -- 46.0 43.7
2015 47.0 44.5
2014 48.7 47.9
2013 50.3 48.6
*Lower rates signify better performance.
Potentially Inappropriate Medications for Patients With Falls*
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016  -- -- -- 47.3 46.6 
2015 47.5 46.8
2014 47.7 48.8
2013 48.2 48.9
*Lower rates signify better performance.
Overall Rate*
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016  -- -- -- 40.4 39.6
2015 40.4 39.3
2014 41.5 41.7
2013 42.5 42.1
*Lower rates signify better performance.
Use of at Least One High-Risk Medication*
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016  -- -- -- 14.1 12.5
2015 11.2 10.5
2014 13.3 12.9
2013 18.2 17.4
*Lower rates signify better performance.
Use of at Least Two High-Risk Medications*
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016  -- -- -- 9.3 8.6
2015 1.7 1.4
2014 2.1 1.9
2013 3.3 2.8
*Lower rates signify better performance.