Clinic visits and prescribing patterns among Veterans Affairs Maryland Health Care System dementia patients

G. B. Rattinger, C. D. Mullins, I. H. Zuckerman, E. Onukwugha, S. Delisle

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)677-683
Number of pages7
JournalJournal of Nutrition, Health and Aging
Volume14
Issue number8
DOIs
StatePublished - Aug 1 2010

Fingerprint

Veterans
Ambulatory Care
Dementia
Delivery of Health Care
Mental Health
Antidepressive Agents
Antipsychotic Agents
Hypnotics and Sedatives
Logistic Models
Electronic Health Records
Marital Status

Keywords

  • Alzheimer's disease
  • dementia
  • Electronic Medical Record
  • Veterans Affairs Health Care System

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Geriatrics and Gerontology

Cite this

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.

In: Journal of Nutrition, Health and Aging, Vol. 14, No. 8, 01.08.2010, p. 677-683.

Research output: Contribution to journalArticle

Rattinger, G. B. ; Mullins, C. D. ; Zuckerman, I. H. ; Onukwugha, E. ; Delisle, S. / Clinic visits and prescribing patterns among Veterans Affairs Maryland Health Care System dementia patients. In: Journal of Nutrition, Health and Aging. 2010 ; Vol. 14, No. 8. pp. 677-683.
@article{155ef9edbbd04583a43b449b6e0639a7,
title = "Clinic visits and prescribing patterns among Veterans Affairs Maryland Health Care System dementia patients",
abstract = "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.",
keywords = "Alzheimer's disease, dementia, Electronic Medical Record, Veterans Affairs Health Care System",
author = "Rattinger, {G. B.} and Mullins, {C. D.} and Zuckerman, {I. H.} and E. Onukwugha and S. Delisle",
year = "2010",
month = "8",
day = "1",
doi = "10.1007/s12603-010-0315-3",
language = "English (US)",
volume = "14",
pages = "677--683",
journal = "Journal of Nutrition, Health and Aging",
issn = "1279-7707",
publisher = "Springer Paris",
number = "8",

}

TY - JOUR

T1 - Clinic visits and prescribing patterns among Veterans Affairs Maryland Health Care System dementia patients

AU - Rattinger, G. B.

AU - Mullins, C. D.

AU - Zuckerman, I. H.

AU - Onukwugha, E.

AU - Delisle, S.

PY - 2010/8/1

Y1 - 2010/8/1

N2 - 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.

AB - 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.

KW - Alzheimer's disease

KW - dementia

KW - Electronic Medical Record

KW - Veterans Affairs Health Care System

UR - http://www.scopus.com/inward/record.url?scp=77957914083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957914083&partnerID=8YFLogxK

U2 - 10.1007/s12603-010-0315-3

DO - 10.1007/s12603-010-0315-3

M3 - Article

VL - 14

SP - 677

EP - 683

JO - Journal of Nutrition, Health and Aging

JF - Journal of Nutrition, Health and Aging

SN - 1279-7707

IS - 8

ER -