The focus of this study is the xerostomic effects and consequences of prescription medications. The project is a population-based, retrospective cohort study to determine and define the magnitude of the association between drug-induced xerostomia and dental caries in adults over 55 who are members of one of two large HMOs: Kaiser Permanente Northwest Division (Portland OR) and HealthPartners (Minneapolis/St Paul) The study is longitudinal and will ascertain dosage levels and episodes of medication use, and rates of extractions, restorative dental care, and costs associated with xerostomic medications. (From pg 27-8): The cohort includes all dental plan members who were 55 years or older on 12/31/98, who were eligible for medical and dental care and had a pharmacy benefit between 11/90 to 12/31/98, who were not taking any medications as of 1/1/90, and who had at least one dental visit during the period. The data analyzed for the study will be derived mostly from computer- generated administrative files for plan members of KPNW and HP. The database information will be supplemented and verified by a review of patient records as well as a questionnaire of a sample of members. The survey will ascertain information on other factors associated with xerostomia and an increased risk of caries and tooth loss, including tobacco and alcohol use, fluid intake, caffeine use, and OTC medications. The extent of xerostomia will not be quantified through clinical examinations. For each dispensing of a drug known to be associated with xerostomia, an episode of drug therapy will be created. Use of medications not previously associated with xerostomia will also be tracked, in order to determine new associations. For each subject, a drug use profile will be created, and associations between this profile and dental utilization (type and number of services as well as cost) will be assessed. The investigators estimate that their study cohort will include well over 100,000 people.
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