Patient characteristics and healthcare utilization patterns associated with unused medications among medicare patients.

Objective: To examine what patient characteristics and healthcare utilization patterns are associated with the likelihood of having unused medications among elderly Medicare patients.

Design: Secondary data analysis combining insurance claims and phone survey data of Medicare Advantage members.

Setting: Regional health plan in Central Pennsylvania.

Participants: 528 Medicare Advantage members (age 65 and older), who had Medicare Part D coverage through Geisinger Health Plan as of December 31, 2013, and completed the phone survey in May of 2014.

Main Outcome: Member survey response indicating whether or not the member had any unused medication at the time of the survey.

Results: 27% of the patients in the sample (142 out of 528) indicated having one or more unused medications. In a bivariate analysis, these patients had higher prevalence of chronic conditions, utilized more medical care (more emergency department visits and physician office visits), and incurred higher cost of care. In a multivariate analysis, patients who received medications with days' supply greater than 30 (odds ratio (OR) = 1.59; p = 0.03) and utilized more acute care (defined as inpatient admissions or emergency department visits) (OR = 4.2; p = 0.04) were more likely to have unused medications. Moreover, patients who were advised by health care professionals about proper medication disposal were less likely to have unused medications (OR = 0.52; p = 0.04).

Conclusion: These findings suggest potential ways to develop effective strategies to reduce amounts of unused medications. Such strategies are likely to involve limiting quantities of medications dispensed at each fill, and patient education on proper disposal of unused medications, particularly during care transitions.