The study's objective is to determine the impact of inappropriate prescribing on health-related outcomes for community dwelling elderly. Inappropriate prescribing is defined by two different criteria: 1) inappropriate medication use as defined by Beers et. al. (1991); 2) inappropriate medication use criteria developed under contract to HCFA in response to the Medicare Catastrophic Coverage Act of 1988. Outcomes measured include functional status (as measured by basic and instrumental activities of daily living, and mobility), health services utilization (hospitalization, institutionalization, emergency room and physician office visits) and associated costs, and mortality. Investigators plan to examine whether the relationship between inappropriate prescribing and outcomes are affected by factors such as age, gender, race, urban/rural residence and comorbidities. A longitudinal design that is population based will be used. The specific hypotheses to be tested are that, compared with elders not receiving inappropriate prescriptions, elderly participants with inappropriate prescribing will have greater functional decline, increased utilization of health services, higher costs and increased likelihood of death after controlling for important covarites (e.g. comorbidities). The study will analyze a pre-existing data set from the National Institute on Aging (NIA)-funded Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE).

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
7R01AG015432-02
Application #
2769447
Study Section
Health Systems Research (HSR)
Project Start
1997-09-01
Project End
2000-08-31
Budget Start
1998-09-01
Budget End
1999-08-31
Support Year
2
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Type
Schools of Pharmacy
DUNS #
168559177
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
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Kaiser, Robert M; Schmader, Kenneth E; Pieper, Carl F et al. (2006) Therapeutic failure-related hospitalisations in the frail elderly. Drugs Aging 23:579-86
Hanlon, Joseph T; Pieper, Carl F; Hajjar, Emily R et al. (2006) Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci 61:511-5
Fillenbaum, Gerda G; Kuchibhatla, Maragatha N; Hanlon, Joseph T et al. (2005) Dementia and Alzheimer's disease in community-dwelling elders taking vitamin C and/or vitamin E. Ann Pharmacother 39:2009-14
Fillenbaum, Gerda G; Hanlon, Joseph T; Landerman, Lawrence R et al. (2004) Impact of inappropriate drug use on health services utilization among representative older community-dwelling residents. Am J Geriatr Pharmacother 2:92-101
Schmader, Kenneth E; Hanlon, Joseph T; Pieper, Carl F et al. (2004) Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly. Am J Med 116:394-401
Ruby, Christine M; Fillenbaum, Gerda G; Kuchibhatla, Maragatha N et al. (2003) Laxative use in the community-dwelling elderly. Am J Geriatr Pharmacother 1:11-7
Lindblad, Catherine I; Hanlon, Joseph T; Artz, Margaret B et al. (2003) Antidiabetic drug therapy of African-American and white community-dwelling elderly over a 10-year period. J Am Geriatr Soc 51:1748-53

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