Students make strides in adherence among elderly

BALTIMORE — If the government paid for drug cost incentives for Medicare patients with congestive heart failure, the program could recoup those costs and more by spending less on expensive hospitalizations for patients. 


That finding was one of several to emerge from research conducted by pharmacy students at the University of Maryland School of Pharmacy. The four students presented their findings on elderly drug adherence at the annual meeting of the Gerontology Society of America in New Orleans.


The researchers were tackling a subject with major implications for pharmacy and health: how elderly patients deal with multiple medical conditions, stay on their medications and avoid the need for emergency hospitalizations.


Doctoral student Jennifer Lloyd, of Maryland’s Doctoral Program in Gerontology, found a link between drug cost incentives and reduced hospitalizations for Medicare patients with congestive heart failure. “A significant proportion of these patients remain untreated,” said Lloyd, who found that higher adherence to most CHF medications was linked with lower Medicare spending over three years.


Sarah Dutcher, a graduate student at the university’s Department of Pharmaceutical Health Services Research, studied drug use patterns among Medicare beneficiaries with heart failure. She found that those with dementia got fewer medications for heart failure than those without it — but that those with both conditions who received and adhered to drugs for heart failure benefited as much as those with no dementia through fewer hospitalizations.


Fifth-year Ph.D. student Jingjing Qian studied drug adherence rates for patients who suffer from both depression and chronic obstructive pulmonary disease. Using Medicare patient records, Qian found that patients with COPD were less likely to use or continue to use antidepressant drugs. Physicians who collaborated with the study said they considered COPD to be more serious than the patients’ depression and tended to treat it first.


Pharmacist H. Keri Yang, a postdoctoral fellow at the school, found that 12.4% of Medicare beneficiaries with depression also had dementia. Those suffering from both conditions tended to be significantly older, had more co-morbidities and used more chronic disease medications than those without dementia, she found. However, beneficiaries with co-morbid depression and dementia had higher risks of hospitalization and were less likely to use any antidepressant.