Quantifying Adverse Drug Event Occurrence and Post-Adverse Drug Event Behaviors in Terms of Andersen Model of Health Care Utilization Constructs; Predisposing Characteristics, Enabling Resources, and Need Factors.

Abstract

Background: When patients experience a symptom, such as a possible ADE, they determine if they want to utilize formal health care services, self-care, or take no action at all. The Andersen Model of Healthcare Utilization addresses predictors that lead to the use of healthcare services or other personal health care decisions, and proposes that an individual’s decision process is influenced by predisposing characteristics, enabling resources, and need factors. There is a gap in knowledge of what post-ADE behaviors older adults perform, and which predictors lead to those behaviors. Objectives: The objectives of this study are to determine, using a nationally representative sample of Medicare/Medicaid enrollees, 1) the prevalence of ADEs in older adults, 2) of those who experienced an ADE, what post-ADE behaviors were performed, and 3) the relationship between enabling factors and post-ADE behaviors. Results: This study shows that older adults are experiencing more ADEs than reported in previous literature. Need factors were all related to the occurrence of an ADE. Individuals performed a variety of post-ADE behaviors. Predisposing characteristics predicted cutting down or stopping medication on own, cutting down or stopping medication with physician authorization, and being hospitalized after experiencing an ADE. Need factors were related to cutting down or stopping medication with doctor’s permission, visiting a doctor or emergency room, and being hospitalized. Finally, enabling resources were influential in talking to a doctor or visiting a doctor or emergency room after having an ADE. Predisposing characteristics were also related to performing a self-care post-ADE behavior. Conclusion: Predisposing characteristics and need factors were significant in predicting ADE risk factors, while the addition of enabling resources help explain post-ADE behaviors.