Continuous Improvement and the Expansion of Quality ... - NCQA

T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • H E D I S M E A S U R E S o f C A R E
MEDICATIoN IN THE ElDERly
The elderly are twice as likely as younger adults to have an adverse drug reaction and are
seven times more likely to be hospitalized as the result of an adverse drug event. 1 The Use
of High-Risk Medications in the Elderly measure assesses how often elderly individuals are
exposed to potentially harmful drugs. 2-4 The Potentially Harmful Drug-Disease Interactions in the
Elderly measure assesses how often patients with a specific diagnosis are prescribed high-risk
medications that are considered potentially dangerous.
• In a 2002–2005 study of 384 American
hospitals, 49 percent of patients received
at least one potentially inappropriate
medication; among patients 65 years of
age and older, 13 percent were given a
potentially harmful medication. 5
• In a study that measured potentially
inappropriate medication use in the elderly,
40 percent of the population filled at least
one prescription for such medications and
13 percent filled two or more. 6
the Case for Improvement
• Exposure to high-risk medications increases
health care costs, including medication
costs, an estimated $7.2 billion annually. 7
• The use of high-risk medications increases
the risk for hospitalization, death and
adverse health outcomes. 6,8
• Mobility problems from dementia are
exacerbated by the use of high-risk
medications, and patients exposed to these
107
medications are more likely to be admitted
to long-term care facilities. 9
• Prescribing harmful drugs to the elderly
population puts them at risk for further
complications, which include falls,
fractures and longer duration of illnesses.
Data from a multidisciplinary falls clinic
and a cooperative adverse drug event
surveillance project show that patients
on five or more medications are twice as
likely to have impaired balance and are
at higher risk for further inappropriate
medication use. 1,10
HEdIs Measure definition
The measures assess two different dimensions
of medication management in the Medicare
population 65 years of age and older.
Potentially Harmful Drug-Disease
Interactions in the Elderly
The percentage of adults 65 and older who
have evidence of an underlying disease,
condition or health concern and who were
dispensed an ambulatory prescription for a
M E A S U R E S T A R G E T E D A T o l D E R A D U l T S