Prescriptions for elderly people vary widely across US

BMJ 2013; 347 doi: (Published 21 October 2013) Cite this as: BMJ 2013;347:f6357
  1. Michael McCarthy
  1. 1Seattle

How many and which drugs elderly Americans take depends a great deal on where they live, a new study has found.1

Researchers at the Dartmouth Atlas Project looked at prescription drug use by Medicare beneficiaries participating in the Medicare’s Part D drug benefit program across 306 regional healthcare markets.

Jeffrey C Munson and Nancy E Morden of the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, were the report’s lead authors. They found that less than a third of the variation in prescribing practices could be explained by the health status of the different regions’ Medicare populations, indicating that non-clinical factors were influencing prescribing practices, including regional practice culture.

In some cases the variation in prescribing practice between cities was as great as threefold and fourfold.

The researchers wrote, “At one end of this spectrum, variation means that some patients are not receiving drugs known to be effective, apparently as a result of where they live. At the other end, elderly patients in some regions are being given drugs known to be risky.”

Overall, the researchers found that use …

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