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Clinic visits and prescribing patterns among Veterans Affairs Maryland Health Care System dementia patients.
Rattinger, G B; Mullins, C D; Zuckerman, I H; Onukwugha, E; Delisle, S.
Afiliación
  • Rattinger GB; Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Baltimore, MD, USA.
J Nutr Health Aging ; 14(8): 677-83, 2010 Oct.
Article en En | MEDLINE | ID: mdl-20922345
OBJECTIVE: Our objective was to determine how patient demographics and outpatient referrals to specialized dementia (DEM) or mental health (MH) clinics influence receipt of anti-dementia (AD), antidepressant (ADEP), antipsychotic (APSY) and sedative-hypnotic (SEDH) medications among veterans with dementia. DESIGN: Retrospective, cross-sectional observational study. SETTING: Veterans Affairs Maryland Health Care System (VAMHCS). PARTICIPANTS: Veterans aged ≥ 60 years with Alzheimer's or related dementia diagnosis after 1999 with minimum of one-year follow-up or death were included. MEASUREMENTS: Retrospective analysis of VAMHCS electronic medical records were used to determine predictors of AD, ADEP, APSY, and SEDH prescribing using logistic regression models that examined visits to DEM or MH clinics, patient age, follow-up time, race/ethnicity and marital status. RESULTS: Among 1209 veterans with average follow-up of 3.2 (SD 1.9) years, 36% percent had MH visits, 38% had DEM visits and 19% visited both clinics. DEM visits were associated with AD and ADEP but not APSY medication receipt (OR(AD:DEM) = 1.47, 95% CI = (1.052, 2.051); OR(ADEP:DEM) = 1.66, 95% CI = (1.193, 2.302); OR(APSY:DEM) = 1.35, 95% CI = (0.941, 1.929)). MH visit was associated with ADEP and APSY medication receipt (OR(AD:MH)\ = 1.16, 95% CI = (0.821, 1.631); OR(ADEP:MH) = 2.83, 95% CI = (2.005, 4.005); OR (APSY:MH) = 4.41, 95% CI = (3.109, 6.255)). CONCLUSION: In the VAMHCS dementia population, visits to DEM or MH specialty clinics increase the odds of receiving AD, ADEP, and APSY medications.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Veteranos / Pautas de la Práctica en Medicina / Demencia / Atención Ambulatoria / Instituciones de Atención Ambulatoria Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Nutr Health Aging Asunto de la revista: CIENCIAS DA NUTRICAO / GERIATRIA Año: 2010 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Veteranos / Pautas de la Práctica en Medicina / Demencia / Atención Ambulatoria / Instituciones de Atención Ambulatoria Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Nutr Health Aging Asunto de la revista: CIENCIAS DA NUTRICAO / GERIATRIA Año: 2010 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia