Determinants of Potentially Inappropriate Medication Use among Community-Dwelling Older Adults

G. Edward Miller, Eric M. Sarpong, Amy J. Davidoff, Eunice Y. Yang, Nicole J. Brandt, Donna M. Fick

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Objective: To examine the determinants of potentially inappropriate medication (PIM) use. Data Sources/Study Setting: U.S. nationally representative data on (n = 16,588) noninstitutionalized older adults (age ≥65) with drug use from the 2006–2010 Medical Expenditure Panel Survey. Study Design: We operationalized the 2012 Beers Criteria to identify PIM use during the year, and we examined associations with individual-level characteristics hypothesized to be quality enabling or related to need complexity. Principal Findings: Almost one-third (30.9 percent) of older adults used a PIM. Multivariate results suggest that poor health status and high-PIM-risk conditions were associated with increased PIM use, while increasing age and educational attainment were associated with lower PIM use. Contrary to expectations, lack of a usual care source of care or supplemental insurance was associated with lower PIM use. Medication intensity appears to be in the pathway between both quality-enabling and need-complexity characteristics and PIM use. Conclusion: Our results suggest that physicians attempt to avoid PIM use in the oldest old but have inadequate focus on the high-PIM-risk conditions. Educational programs targeted to physician practice regarding high-PIM-risk conditions and patient literacy regarding medication use are potential responses.

Original languageEnglish (US)
Pages (from-to)1534-1549
Number of pages16
JournalHealth Services Research
Issue number4
StatePublished - Aug 2017

All Science Journal Classification (ASJC) codes

  • Health Policy


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