ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2013
Regional differences in prescribing quality among elder veterans and the impact of rural residence.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00265538 (Implementing Evidence-based Treatment of Hypertension), which is not on this map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Implementing Evidence-based Treatment of Hypertension
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Factors associated with potentially inappropriate prescriptions and barriers to medicines optimisation among older adults in primary care settings: a systematic review.Family medicine and community health · 2021Pooled it
- Factors associated with potentially inappropriate medication use in community-dwelling older adults in the United States: a systematic review.The International journal of pharmacy practice · 2019Pooled it
- Pooled it
- Identifying Contextual Barriers and Potential Solutions to Improving Hypertension Management in Rural Communities in the United States: Qualitative Study From 2 North Carolina Counties.Journal of the American Heart Association · 2026Article
- Unwarranted variation in potentially inappropriate medication in general practice: a Danish nationwide register-based cohort study.BMJ open · 2026Article
- Antibiotic Prescribing in Outpatient Settings: Rural Patients Are More Likely to Receive Fluoroquinolones and Longer Antibiotic Courses.Antibiotics (Basel, Switzerland) · 2023Article
- Measuring rurality in health services research: a scoping review.BMC health services research · 2022Article
- Postmortem screening of opioids, benzodiazepines, and alcohol among rural and urban suicide decedents.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- Evaluation of Factors Associated With Appropriate Drug Prescription and Effectiveness of Informative and Educational Interventions-The EDU.RE.DRUG Project.Frontiers in pharmacology · 2022Article
- Review
- Geographic Variation in the Prevalence of High-Risk Medication Use Among Medicare Part D Beneficiaries by Hospital Referral Region.Journal of managed care & specialty pharmacy · 2020Article
- Factors Associated With Potentially Inappropriate Phosphodiesterase-5 Inhibitor Use for Pulmonary Hypertension in the United States, 2006 to 2015.Circulation. Cardiovascular quality and outcomes · 2020Article
- Prevalence of Potentially Inappropriate Medication use in older drivers.BMC geriatrics · 2019Article
- Geographic Disparities in Mortality Risk Within a Racially Diverse Sample of U.S. Veterans with Traumatic Brain Injury.Health equity · 2018Article
- Risk Factors for Initiation of Potentially Inappropriate Medications in Community-Dwelling Older Adults with and without Alzheimer's Disease.Drugs & aging · 2017Article
- Differences in Benzodiazepine Receptor Agonist Use in Rural and Urban Older Adults.Drugs - real world outcomes · 2016Article
- Prescription of potentially inappropriate medication in Korean older adults based on 2012 Beers Criteria: a cross-sectional population based study.BMC geriatrics · 2016Article
- General practice variation when initiating long-term prescribing of proton pump inhibitors: a nationwide cohort study.BMC family practice · 2016Article
- Variation in Formulary Management Practices Within the Department of Veterans Affairs Health Care System.Journal of managed care & specialty pharmacy · 2016Article
- Regional variation in medication-taking behaviour of new users of oral anti-hyperglycaemic therapy in Ireland.Irish journal of medical science · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
purposeMedication safety is a critical concern for older adults. Regional variation in potentially inappropriate prescribing practices may reflect important differences in health care quality. Therefore, the objectives of this study were to characterize prescribing quality variation among older adults across geographic region, and to compare prescribing quality across rural versus urban residence.
methodsCross-sectional study of 1,549,824 older adult veterans with regular Veterans Affairs (VA) primary care and medication use during fiscal year 2007. Prescribing quality was measured by 4 indicators of potentially inappropriate prescribing: Zhan criteria drugs to avoid, Fick criteria drugs to avoid, therapeutic duplication, and drug-drug interactions. Frequency differences across region and rural-urban residence were compared using adjusted odds-ratios.
findingsSignificant regional variation was observed for all indicators. Zhan criteria frequencies ranged from 13.2% in the Northeast to 21.2% in the South. Nationally, rural veterans had a significantly increased risk for inappropriate prescribing according to all quality indicators. However, regional analyses revealed this effect was limited to the South and Northeast, whereas rural residence was neutral in the Midwest and protective in the West.
conclusionsSignificant regional variation in prescribing quality was observed among older adult veterans, mirroring recent findings among Medicare beneficiaries. The association between rurality and prescribing quality is heterogeneous, and relying solely on national estimates may yield misleading conclusions. Although we documented important variations in prescribing quality, the underlying factors driving these trends remain unknown, and they are a vital area for future research affecting older adults in both VA and non-VA health systems.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.