Rx Details Potentially Inappropriate Medications

Rx Details
Potentially Inappropriate Medications
Jan 20,
2012
Elderly Patients and Potentially Inappropriate Medications
HealthPartners is sending provider letters regarding the prescribing of potentially inappropriate
medications (PIMs) in the elderly.
Inappropriate medications are defined as those that have a risk of adverse outcomes outweighing the
potential benefits for most elderly patients. The inappropriate drugs most frequently prescribed to
HealthPartners members include cyclobenzaprine (Flexeril), nitrofurantoin (Macrobid, Macrodantin),
conjugated estrogens (such as Premarin), and hydroxyzine (Vistaril). Members are identified if they
receive at least two prescriptions for a PIM within 6 months.
In 2011, 11% of elderly HealthPartners members were prescribed at least 1 PIM, and 1% of members
received 2 or more different PIM medications. Nationally, 16% of elderly Medicare members were
prescribed at least 1 PIM and 2.5% received at least 2 PIM’s.
Prescribing of PIMs in the elderly is assessed as a Medicare Star quality measure. Performance on this
measure is made publicly available. While the rate of PIM prescribing among HealthPartners members
has improved since 2010, HealthPartners has not yet achieved optimal performance and a 5-star rating.
Providers are asked to review drug therapy carefully in the elderly for muscle relaxants, antibiotics,
hormone replacement therapy, and antihistamines. Concerns and alternatives are attached.
For more information, contact Laura Fortuna PharmD at [email protected].
Brought to you by the HealthPartners Department of Clinical Pharmacy.