Abstract
Objective
To examine the different sources of medications, the most common drug classes filled,
and the characteristics associated with Medicare Part D pharmacy use in veterans with
spinal cord injury/disorder (SCI/D).
Design
Retrospective, cross-sectional, observational study.
Setting
Outpatient clinics and pharmacies.
Participants
Veterans (N=13,442) with SCI/D using Medicare or Veteran Affairs pharmacy benefits.
Interventions
Not applicable.
Main Outcome Measures
Characteristics and top 10 most common drug classes were examined in veterans who
(1) used VA pharmacies only; (2) used both VA and Medicare Part D pharmacies; or (3)
used Part D pharmacies only. Chi-square tests and multinomial logistic regression
analyses were used to determine associations between various patient variables and
source of medications. Patient level frequencies were used to determine the most common
drug classes.
Results
A total of 13,442 veterans with SCI/D were analyzed in this study: 11,788 (87.7%)
used VA pharmacies only, 1281 (9.5%) used both VA and Part D pharmacies, and 373 (2.8%)
used Part D pharmacies only. Veterans older than 50 years were more likely to use
Part D pharmacies, whereas those with traumatic injury, or secondary conditions, were
less associated with the use of Part D pharmacies. Opioids were the most frequently
filled drug class across all groups. Other frequently used drug classes included skeletal
muscle relaxants, gastric medications, antidepressants (other category), anticonvulsants,
and antilipemics.
Conclusions
Approximately 12% of veterans with SCI/D are receiving medication outside the VA system.
Polypharmacy in this population of veterans is relatively high, emphasizing the importance
of health information exchange between systems for improved care for this medically
complex population.
Keywords
List of abbreviations:
Dual (Medicare Part D and VA pharmacy), HIE (health information exchange), Part D only (Medicare Part D pharmacy only), SCI/D (spinal cord injury/disorder), SCIDO (Spinal Cord Injury and Disorders Outcomes), UTI (urinary tract infection), VA (Department of Veterans Affairs), Veterans Affairs Only (Veterans Affairs pharmacy only)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 06, 2018
Footnotes
Supported by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service (grant no. IIR 07-165-2). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
