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Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D.

Publication ,  Journal Article
Schleiden, LJ; Thorpe, CT; Cashy, JP; Gellad, WF; Good, CB; Hanlon, JT; Mor, MK; Niznik, JD; Pleis, JR; Van Houtven, CH; Thorpe, JM
Published in: Res Social Adm Pharm
June 2019

BACKGROUND: Obtaining prescription medications from multiple health systems may complicate coordination of care. Older Veterans who obtain medications concurrently through Veterans Affairs (VA) benefits and Medicare Part D benefits (dual users) are at higher risk of unintended negative outcomes. OBJECTIVE: To explore characteristics predicting dual drug benefit use from both VA and Medicare Part D in a national sample of older Veterans with dementia. METHODS: Administrative data were obtained from the VA and Medicare for a national sample of 110,828 Veterans with dementia ages 68 and older in 2010. Veterans were classified into three drug benefit user groups based on the source of all prescription medications they obtained in 2010: VA-only, Part D-only, and Dual Use. Multinomial logistic regression was used to examine predictors of drug benefit user group. The source of prescriptions was described for each of the ten most frequently used drug classes and opioids. RESULTS: Fifty-six percent of Veterans received all of their prescription medications from VA-only, 28% from Part D-only, and 16% from both VA and Part D. Veterans who were eligible for Medicaid or who had a priority group score conferring less generous drug benefits within the VA were more likely to be Part D-only or dual users. Nearly one fourth of Veterans taking opioids concurrently received opioid prescriptions from dual sources (24.7%). CONCLUSIONS: Medicaid eligibility and Veteran priority group status, which largely decrease copayments for drugs obtained outside versus within the VA, respectively, were the main factors predicting drug user benefit group. Policies to encourage single-system prescribing and enhance communication across health systems are crucial to preventing negative health outcomes related to care fragmentation.

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Published In

Res Social Adm Pharm

DOI

EISSN

1934-8150

Publication Date

June 2019

Volume

15

Issue

6

Start / End Page

701 / 709

Location

United States

Related Subject Headings

  • Veterans Health
  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Pharmacology & Pharmacy
  • Medicare Part D
  • Male
  • Inappropriate Prescribing
  • Humans
  • Female
 

Citation

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Schleiden, L. J., Thorpe, C. T., Cashy, J. P., Gellad, W. F., Good, C. B., Hanlon, J. T., … Thorpe, J. M. (2019). Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D. Res Social Adm Pharm, 15(6), 701–709. https://doi.org/10.1016/j.sapharm.2018.09.001
Schleiden, Loren J., Carolyn T. Thorpe, John P. Cashy, Walid F. Gellad, Chester B. Good, Joseph T. Hanlon, Maria K. Mor, et al. “Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D.Res Social Adm Pharm 15, no. 6 (June 2019): 701–9. https://doi.org/10.1016/j.sapharm.2018.09.001.
Schleiden LJ, Thorpe CT, Cashy JP, Gellad WF, Good CB, Hanlon JT, et al. Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D. Res Social Adm Pharm. 2019 Jun;15(6):701–9.
Schleiden, Loren J., et al. “Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D.Res Social Adm Pharm, vol. 15, no. 6, June 2019, pp. 701–09. Pubmed, doi:10.1016/j.sapharm.2018.09.001.
Schleiden LJ, Thorpe CT, Cashy JP, Gellad WF, Good CB, Hanlon JT, Mor MK, Niznik JD, Pleis JR, Van Houtven CH, Thorpe JM. Characteristics of dual drug benefit use among veterans with dementia enrolled in the Veterans Health Administration and Medicare Part D. Res Social Adm Pharm. 2019 Jun;15(6):701–709.
Journal cover image

Published In

Res Social Adm Pharm

DOI

EISSN

1934-8150

Publication Date

June 2019

Volume

15

Issue

6

Start / End Page

701 / 709

Location

United States

Related Subject Headings

  • Veterans Health
  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Pharmacology & Pharmacy
  • Medicare Part D
  • Male
  • Inappropriate Prescribing
  • Humans
  • Female