A research letter examining patient-care practices in the Veterans Affairs (VA) health system found that medication changes among elderly patients during one year of follow-up are common.

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The research was published June 10 in JAMA: Internal Medicine,  and quantified cumulative changes in long-term, regular-use medications — that is, those dispensed with more than a 25-day supply and no indication of "as needed" — among elderly patients over the course of one year. The analysis included 350,415 military veterans with a mean age of 74 years.

At the beginning of the study, patients were taking a median of four medications for chronic diseases. At one year, there was little change, with 77 percent of patients taking one more or one fewer medication. However, patients had a median of four medication changes over the course of the study, 88 percent had at least one change and 12 percent had 10 or more changes.

Moving forward, study investigators suggest that that tracking medication changes may be a "novel, valuable and readily measurable marker of patients at high risk of medication-related problems." They caution, however, that "multiple medication changes may often benefit patients … and the rate of medication changes should not be interpreted as a measure of quality of care." Future validation of the findings is needed, they said.

Keywords: Follow-Up Studies, Chronic Disease, Veterans, Biomarkers, Military Personnel, United States Department of Veterans Affairs

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