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dc.contributor.authorSimon, Steven R.
dc.contributor.authorAndrade, Susan E.
dc.contributor.authorEllis, Jennifer L.
dc.contributor.authorNelson, Winnie W.
dc.contributor.authorGurwitz, Jerry H.
dc.contributor.authorLafata, Jennifer Elston
dc.contributor.authorDavis, Robert L.
dc.contributor.authorFeldstein, Adrianne
dc.contributor.authorRaebel, Marsha A.
dc.date2022-08-11T08:09:23.000
dc.date.accessioned2022-08-23T16:29:05Z
dc.date.available2022-08-23T16:29:05Z
dc.date.issued2005-12-01
dc.date.submitted2009-09-25
dc.identifier.citationJ Am Geriatr Soc. 2005 Dec;53(12):2165-9.
dc.identifier.issn0002-8614
dc.identifier.pmid16398903
dc.identifier.pmid16398903
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37164
dc.description.abstractOBJECTIVES: To identify correlates of laboratory monitoring errors in elderly health maintenance organization (HMO) members at the initiation of therapy with cardiovascular medications. DESIGN: Cross-sectional study in 10 HMOs. SETTING: United States. PARTICIPANTS: From a 2 million-member sample, individuals aged 65 and older who received one of seven cardiovascular medications (angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), amiodarone, digoxin, diuretics, potassium supplements, and statins) and did not have recommended baseline monitoring performed during the 180 days before or 14 days after the index dispensing. MEASUREMENTS: The proportion of members receiving each drug for whom recommended laboratory monitoring was not performed. Laboratory monitoring error rates stratified by sex, age group, chronic disease score, and HMO site were examined, and logistic regression was used to identify predictors of laboratory monitoring errors. RESULTS: Error rates varied by medication class, ranging from 23% of patients receiving potassium supplementation without serum potassium and serum creatinine monitoring to 58% of patients receiving amiodarone who did not have recommended monitoring for thyroid and liver function. Highest error rates occurred in the youngest elderly for ACE inhibitors, ARBs, digoxin, diuretics, and potassium supplements, although in patients receiving amiodarone and statins, errors were most frequent in the oldest elderly. Errors occurred more frequently in patients with less comorbidity. CONCLUSION: Laboratory monitoring errors occurred frequently in elderly HMO members at the initiation of therapy with cardiovascular medications. Further study must examine the association between these errors and adverse outcomes.
dc.language.isoen_US
dc.publisherBlackwell Science
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16398903&dopt=Abstract">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1111/j.1532-5415.2005.00498.x
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectCardiovascular Agents
dc.subjectCardiovascular Diseases
dc.subjectComorbidity
dc.subjectCross-Sectional Studies
dc.subjectDrug Monitoring
dc.subjectFemale
dc.subjectHealth Maintenance Organizations
dc.subjectHumans
dc.subjectLaboratory Techniques and Procedures
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMedication Errors
dc.subjectRisk Factors
dc.subjectUnited States
dc.subjectHealth Services Research
dc.subjectMedicine and Health Sciences
dc.titleBaseline laboratory monitoring of cardiovascular medications in elderly health maintenance organization enrollees.
dc.typeJournal Article
dc.source.journaltitleJournal of the American Geriatrics Society
dc.source.volume53
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/55
dc.identifier.contextkey1016943
html.description.abstract<p>OBJECTIVES: To identify correlates of laboratory monitoring errors in elderly health maintenance organization (HMO) members at the initiation of therapy with cardiovascular medications.</p> <p>DESIGN: Cross-sectional study in 10 HMOs.</p> <p>SETTING: United States.</p> <p>PARTICIPANTS: From a 2 million-member sample, individuals aged 65 and older who received one of seven cardiovascular medications (angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), amiodarone, digoxin, diuretics, potassium supplements, and statins) and did not have recommended baseline monitoring performed during the 180 days before or 14 days after the index dispensing.</p> <p>MEASUREMENTS: The proportion of members receiving each drug for whom recommended laboratory monitoring was not performed. Laboratory monitoring error rates stratified by sex, age group, chronic disease score, and HMO site were examined, and logistic regression was used to identify predictors of laboratory monitoring errors.</p> <p>RESULTS: Error rates varied by medication class, ranging from 23% of patients receiving potassium supplementation without serum potassium and serum creatinine monitoring to 58% of patients receiving amiodarone who did not have recommended monitoring for thyroid and liver function. Highest error rates occurred in the youngest elderly for ACE inhibitors, ARBs, digoxin, diuretics, and potassium supplements, although in patients receiving amiodarone and statins, errors were most frequent in the oldest elderly. Errors occurred more frequently in patients with less comorbidity.</p> <p>CONCLUSION: Laboratory monitoring errors occurred frequently in elderly HMO members at the initiation of therapy with cardiovascular medications. Further study must examine the association between these errors and adverse outcomes.</p>
dc.identifier.submissionpathmeyers_pp/55
dc.contributor.departmentDepartment of Medicine, Division of Geriatric Medicine
dc.contributor.departmentMeyers Primary Care Institute


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