The journal of nutrition, health & aging

, Volume 14, Issue 8, pp 677–683

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
JNHA: Clinical Neurosciences

DOI: 10.1007/s12603-010-0315-3

Cite this article as:
Rattinger, G.B., Mullins, C.D., Zuckerman, I.H. et al. J Nutr Health Aging (2010) 14: 677. doi:10.1007/s12603-010-0315-3

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.

Key words

Alzheimer's diseasedementiaVeterans Affairs Health Care SystemElectronic Medical Record

Copyright information

© Serdi and Springer Verlag France 2010

Authors and Affiliations

  • G. B. Rattinger
    • 1
  • C. D. Mullins
    • 1
  • I. H. Zuckerman
    • 1
  • E. Onukwugha
    • 1
  • S. Delisle
    • 2
    • 3
  1. 1.Pharmaceutical Health Services Research DepartmentUniversity of Maryland School of PharmacyBaltimoreUSA
  2. 2.Division of Pulmonary and Critical Care MedicineUniversity of Maryland School of MedicineBaltimoreUSA
  3. 3.Veterans Affairs Maryland Health Care SystemBaltimoreUSA