Using more comprehensive medication review (CMR) sessions is linked to discontinuing potentially inappropriate medications (PIM). The reviews could stop older adults from taking unneeded medications, according to a new study.
CMRs can be useful to lower PIM use, and their positive effects were not a function of race or ethnicity, a report published Monday in the Journal of the American Society of Geriatrics found.
Medicare’s nationwide medication therapy management (MTM) program mandates that people on Part D plans to have an annual CMR. Over 40% of older adults in the United States use at least five or more medications — a situation called polypharmacy.
“This is the first nationwide study to find that receipt of CMR was associated with a higher chance of PIM discontinuation for multimorbid older adults with polypharmacy,” the authors wrote. “This finding demonstrates the value of the Medicare MTM program’s CMR, because PIMs are associated with persistent physical disability, hospitalization, emergency department use and total healthcare expenditures.”
Investigators matched 24,368 people who underwent CMR to the same number of people who did not have a CMR. The median age of people was 74 to 75, and 35% were males. Up to 87% of the people studied were white, while 8% were non-Hispanic Black, 2% were non-Hispanic Asian and 2% were Hispanic beneficiaries. The median number of PIMs people were on was one. Data came from 2013 to 2019.
Approximately 42% resided in the Southern United States, 30% lived in a rural area and 30% were dual-Medicaid enrollees. The three most common comorbidities people experienced were dyslipidemia (77%), hypertension (54%) and diabetes (43%). The PIMs most commonly discontinued after CMR were glimepiride, zolpidem, digoxin, amitriptyline and nitrofurantoin.
The authors noted that the absence of differences in effects of CMRs were timely, since Medicare is aiming to reduce health disparities.
