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Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia.

Publication ,  Journal Article
Thorpe, CT; Gellad, WF; Mor, MK; Cashy, JP; Pleis, JR; Van Houtven, CH; Schleiden, LJ; Hanlon, JT; Niznik, JD; Carico, RL; Good, CB; Thorpe, JM
Published in: Health Serv Res
December 2018

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.

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Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

December 2018

Volume

53 Suppl 3

Issue

Suppl Suppl 3

Start / End Page

5375 / 5401

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Medication Adherence
  • Medicare Part D
  • Male
  • Logistic Models
  • Hypertension
  • Humans
  • Health Policy & Services
  • Female
 

Citation

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Thorpe, C. T., Gellad, W. F., Mor, M. K., Cashy, J. P., Pleis, J. R., Van Houtven, C. H., … Thorpe, J. M. (2018). Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia. Health Serv Res, 53 Suppl 3(Suppl Suppl 3), 5375–5401. https://doi.org/10.1111/1475-6773.13055
Thorpe, Carolyn T., Walid F. Gellad, Maria K. Mor, John P. Cashy, John R. Pleis, Courtney H. Van Houtven, Loren J. Schleiden, et al. “Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia.Health Serv Res 53 Suppl 3, no. Suppl Suppl 3 (December 2018): 5375–5401. https://doi.org/10.1111/1475-6773.13055.
Thorpe CT, Gellad WF, Mor MK, Cashy JP, Pleis JR, Van Houtven CH, et al. Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia. Health Serv Res. 2018 Dec;53 Suppl 3(Suppl Suppl 3):5375–401.
Thorpe, Carolyn T., et al. “Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia.Health Serv Res, vol. 53 Suppl 3, no. Suppl Suppl 3, Dec. 2018, pp. 5375–401. Pubmed, doi:10.1111/1475-6773.13055.
Thorpe CT, Gellad WF, Mor MK, Cashy JP, Pleis JR, Van Houtven CH, Schleiden LJ, Hanlon JT, Niznik JD, Carico RL, Good CB, Thorpe JM. Effect of Dual Use of Veterans Affairs and Medicare Part D Drug Benefits on Antihypertensive Medication Supply in a National Cohort of Veterans with Dementia. Health Serv Res. 2018 Dec;53 Suppl 3(Suppl Suppl 3):5375–5401.
Journal cover image

Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

December 2018

Volume

53 Suppl 3

Issue

Suppl Suppl 3

Start / End Page

5375 / 5401

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Medication Adherence
  • Medicare Part D
  • Male
  • Logistic Models
  • Hypertension
  • Humans
  • Health Policy & Services
  • Female