In a recent study, UNC Eshelman School of Pharmacy researchers found that veterans 65 years and older who used both Veterans Affairs and Medicare Part D drug benefits were associated with a higher exposure to potentially unsafe medication prescribing.
Among the 279,940 medicare-eligible older veterans receiving a prescription from the VA, researchers found 18.9 percent also received health care elsewhere (dual use).
Research indicated that dual use of VA and Part D prescription drug benefits correlated with an almost two-fold increase in the odds of exposure to any potentially unsafe medication compared with VA-only use, and more than three times the odds of exposure to severe drug-to-drug interactions.
Researchers said while dual eligibility may increase access to necessary medications, receiving prescriptions from two systems may also fragment care and undermine prescribing safety.
“To mitigate these potential risks, policies intended to expand access to non-VA providers must ensure patient information is shared and integrated into routine practice for all patients seeking care across multiple health care systems,” said researcher Joshua M. Thorpe, Ph.D.
Following the publication of their findings in JAMA Internal Medicine, the team received commentary from David Shulkin, MD, former United States Secretary of Veterans Affairs.
“The VA’s efforts to reform are necessary and good. Greater choice for veterans is also good. However, without the appropriate clinical safeguards, as this study by Thorpe and colleagues demonstrates, unintended consequences are possible,” Shulkin said in his letter. “It is essential that access standards be based on sound health policy. Our veterans deserve no less.”
Researchers Joshua M. Thorpe, Ph.D, MPH; Carolyn T. Thorpe, Ph.D, MPH; Loren Schleiden, MPH; John Cashy, MS; Ronald Carico, Pharm.D., MPH; Walid F. Gellad, MD, MPH; and Courtney Harold Van Houtven, Ph.D., authored the study.