Evaluating the Use of Medicare Part D in the Spinal Cord Injury/Disorder Veteran Population

Publication date: Available online 6 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Maya N. Hatch, Jason Raad, Katie Suda, Kevin T. Stroupe, Alice J. Hon, Bridget M. Smith
ObjectiveTo examine the different sources of medications, the most common drugs classes filled, and the characteristics associated with Medicare Part D pharmacy use in Veterans with spinal cord injuries/disorders (SCI/D).DesignThis was a retrospective, cross-sectional observation study.SettingDepartment of Veterans Affairs (VA)ParticipantsVeterans with SCI/D using Medicare or Veteran Affairs Pharmacy benefits.InterventionsNoneMain Outcome Measure(s)Characteristics and top 10 most common drug classes were examined in Veterans who (1) used VA pharmacies only, (2) dually used VA and Part D pharmacies, or (3) Part D pharmacies only. Chi-squared tests and multinomial logistic regression analyses were used to determine associations of patient variables. Patient level frequencies were used to determine the most common drug classes.Results13,442 Veterans with SCI/D were analyzed in this study: 11,788 (87.7%) were VA Only users, 1,281 (9.5%) used both VA and Part D, and 373 (2.8%) used Part D Only. Veterans over the age of 50 were more likely to use Part D, whereas those with a traumatic injury, or secondary conditions, were less associated with Part D use. Opioids were the most frequently filled drug class across all groups. Other frequently used drug classes included skeletal muscle relaxants, gastric medications, anti-depressants (other), anticonvulsants, and antilipemics.ConclusionApproximately 12% of Veterans with a SCI/D are receiving medication outside of 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.



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