Observational studyAnnals of internal medicine2017
Dual Health Care System Use and High-Risk Prescribing in Patients With Dementia: A National Cohort Study.
Observational study in Annals of internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed.
- Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025Article
- Pharmacist-Driven Deprescribing to Reduce Anticholinergic Burden in Veterans With Dementia.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Impact of VA Hematology/Oncology Clinical Pharmacy Practitioners in the Review of Community Prescriptions for Specialty Medications.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Care cascades following low-value cervical cancer screening in dually enrolled Veterans.Journal of the American Geriatrics Society · 2024Article
- After-hours, Severity, and Distance are Associated with Non-VHA Emergency Department Use for Older Veterans: Insights from a Regional Health Information Exchange.Journal of geriatric emergency medicine · 2024Article
- Central Nervous System-Active Prescriptions in Older Veterans: Trends in Prevalence, Prescribers, and High-risk Populations.Journal of general internal medicine · 2023Article
- Use of high cost care among Veterans with comorbid mental illness and Alzheimer's Disease and related dementias.PloS one · 2023Article
- Assessment of Care Cascades Following Low-Value Prostate-Specific Antigen Testing Among Veterans Dually Enrolled in the US Veterans Health Administration and Medicare Systems.JAMA network open · 2022Article
- Polypharmacy in Older Adults with Alzheimer's Disease.Medicina (Kaunas, Lithuania) · 2022Review
- National Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship.Open forum infectious diseases · 2022Article
- Outpatient Care Fragmentation and Acute Care Utilization in Veterans Affairs Home-Based Primary Care.JAMA network open · 2022Article
- Optimizing care coordination to address social determinants of health needs for dual-use veterans.BMC health services research · 2022Article
- Benzodiazepine Prescribing from VA and Medicare to Dually Enrolled Older Veterans: A Retrospective Cohort Study.Journal of general internal medicine · 2021Article
- Polypharmacy among older adults with dementia compared with those without dementia in the United States.Journal of the American Geriatrics Society · 2021Article
- VA-Community Dual Care: Veteran and Clinician Perspectives.Journal of community health · 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
- The advanced care coordination program: a protocol for improving transitions of care for dual-use veterans from community emergency departments back to the Veterans Health Administration (VA) primary care.BMC health services research · 2019Article
- Patterns of opioid prescriptions received prior to unintentional prescription opioid overdose death among Veterans.Research in social & administrative pharmacy : RSAP · 2019Article
- Dual Receipt of Prescription Opioids From the Department of Veterans Affairs and Medicare Part D and Prescription Opioid Overdose Death Among Veterans: A Nested Case-Control Study.Annals of internal medicine · 2019Article
- Pharmacy Integration.American health & drug benefits · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundRecent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia.
objectiveTo investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing.
designRetrospective cohort study.
settingNational VA outpatient care facilities in 2010.
participants75 829 veterans with dementia who were continuously enrolled in Medicare from 2007 to 2010; 80% were VA-only users, and 20% were VA-Medicare Part D (dual) users. MEASUREMENTS: Augmented inverse propensity weighting was used to estimate the effect of dual-system versus VA-only prescribing on 4 indicators of PUM prescribing in 2010: any exposure to Healthcare Effectiveness Data and Information Set (HEDIS) high-risk medication in older adults (PUM-HEDIS), any daily exposure to prescriptions with a cumulative Anticholinergic Cognitive Burden (ACB) score of 3 or higher (PUM-ACB), any antipsychotic prescription (PUM-antipsychotic), and any PUM exposure (any-PUM). The annual number of days of each PUM exposure was also examined.
resultsCompared with VA-only users, dual users had more than double the odds of exposure to any-PUM (odds ratio [OR], 2.2 [95% CI, 2.2 to 2.3]), PUM-HEDIS (OR, 2.4 [CI, 2.2 to 2.8]), and PUM-ACB (OR, 2.1 [CI, 2.0 to 2.2]). The odds of PUM-antipsychotic exposure were also greater in dual users (OR, 1.5 [CI, 1.4 to 1.6]). Dual users had an adjusted average of 44.1 additional days of any-PUM exposure (CI, 37.2 to 45.0 days). LIMITATION: Observational study design of veteran outpatients only.
conclusionAmong veterans with dementia, rates of PUM prescribing are significantly higher among dual-system users than with VA-only users. PRIMARY FUNDING SOURCE: U.S. Department of Veterans Affairs.
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