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VA Pittsburgh study on dual use of health systems nets best research paper


January 28, 2018

Pittsburgh , PA — VA’s Health Services Research and Development arm named VA Pittsburgh Healthcare System researcher Joshua Thorpe’s study “Dual Health Care System Use and High-Risk Prescribing in Patients with Dementia” as one of two of the best research papers of 2017.

The paper details Thorpe and colleagues’ study of VA and Medicare data to identify nearly 76,000 Veterans with dementia who were enrolled in both health care systems from 2007 through 2010. They found that compared with VA-users only, Veterans who used both VA and Medicare (dual-users) had more than double the odds of exposure to potentially unsafe medications – demonstrating that receipt of prescription medications across unconnected care systems increases the risk for unsafe prescribing. The study was published in the Annals of Internal Medicine in December 2016.

Dr. David Gifford of VA’s Geriatrics and Gerontology Advisory Committee highlighted the findings’ impact in an accompanying editorial.

“On the surface, the study by Thorpe and colleagues seems to be only about medication prescribing for dementia in the VA system, but it could serve as the basis for an entire medical school course on health policy,” wrote Gifford. 

After publication, VA asked Thorpe to fast-track new approaches to reduce this risk for Veterans.  The VA Center for Medication Safety is now developing a tracker to monitor VA databases for suboptimal prescribing and potential adverse drug events. The tracker will alert local VA medical facilities of risks and prompt them to better coordinate care among high-risk Veterans using dual health care systems.

VHA is responsible for managing care for one of the largest cohorts of patients with dementia in the U.S. As the Veteran population ages, this number is expected to double by 2030. Thus, improving dementia care is critical to VHA clinical operations.

Thorpe is a core investigator for VA’s Center for Health Equity Research and Promotion (CHERP) at VA Pittsburgh. He is also an associate professor at the University of Pittsburgh School of Pharmacy.

This national award honors articles on research funded by VA Health Services Research and Development or by the Quality Enhancement Research Initiative. The research must involve Veterans, be important to Veterans’ health and care, and to the VA health care system.



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