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Drug-disease interactions: assessment by disease state

Pugh MJ, Starner C, Berlowitz D, Hanlon JT. Drug-disease interactions: assessment by disease state. Poster session presented at: American Geriatrics Society Annual Meeting; 2010 May 16; Orlando, FL.


Purpose:To identify the prevalence of exposure to drug-disease interactions (DDI) as defined by Health Employer Data Information Set (HEDIS) criteria community dwelling veterans. Methods: We used national VA inpatient, outpatient and pharmacy data to identify veterans 65 years or older in 2006 who received VA care 2004-2006.We used ICD-9-CM codes to identify individuals with diagnoses of dementia, a history of falls, peptic ulcer disease or chronic renal failure from 2004-2006.We then identified individuals who received medications considered relatively or potentially contraindicated for individuals with those conditions by the HEDIS criteria in 2006 (anticholinergics:-dementia; conventional antipsychotics or benzodiazepines or tricyclic antidepressants or sedative hypnotics: and falls; aspirin and non-aspirin nonsteroidal anti-inflammatory (NSAIDS) and peptic ulcer disease PUD); Non-aspirin NSAIDS and chronic renal failure).We then identified the prevalence of DDI exposure in the overall cohort, and then the prevalence of DDI within each condition. Results: Approximately 1,480,835 individuals met study criteria; N = 45,610 older veterans (3.08%) had one or more DDI exposures in 2006. DDI prevalence was 1.36% for those with dementia, 0.47 for those with a history of falls, 0.63% for those with PUD, and .83% for those with chronic renal failure.When examined within disease cohorts, rates of DDI ranged from 9.54% for individuals with chronic renal failure, 16.1% for those with a history of falls, 19.5% for those with PUD, to 21.13% for individuals with dementia. Conclusions: While the population prevalence of DDI appears low, DDI among patients with specific disease states reveals substantial numbers of patients received potentially inappropriate medication based on the HEDIS DDI criteria. Future studies will examine factors associated with DDI exposure and their impact on health outcomes.

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