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Racial and Ethnic Differences in Potentially Inappropriate Medication Use Among Medicare Beneficiaries
Eli Raver, Jeah Kyoungrae Jung, Caroline Carlin, Roger D Feldman, Sheldon M. Retchin, Wendy Xu. JAMA Network Open, 2025-04-14
Topic: Risk, prevention and care in population studies
The study sample included 21 193 170 patients with 32 199 587 beneficiary-year observations (mean [SD] age, 75.5 [7.3] years; 18 936 697 [58.8%] female; 983 513 [3.1%] Asian or Pacific Islander, 3 190 515 [9.9%] Black, 2 710 930 [8.4%] Hispanic, and 25 314 629 [78.6%] White). Compared with White beneficiaries, the rates of high-risk medication use were 1.7 [95% CI, -1.8 to -1.6] percentage points lower for Asian or Pacific Islander beneficiaries, 3.4 [95% CI, -3.4 to -3.3] percentage points lower for Black beneficiaries, and 0.6 [95% CI, -0.6 to -0.5] percentage points lower for Hispanic beneficiaries. Similarly, White beneficiaries had the highest rates of potentially harmful drug-disease interactions among those with dementia as well as those with a history of falls. The pattern of racial and ethnic differences was similar in analyses stratified by enrollment in TM or MA plans. However, the differences between White individuals and other groups were smaller in MA than in TM plans for all comparisons. Conclusions and Relevance: In this cross-sectional study of 32 199 587 Medicare beneficiary-years from 2016 to 2019, White Medicare beneficiaries had consistently higher rates of PIM use compared with other racial and ethnic groups. The observed differences may be partially explained by racial and ethnic differences in overall prescription drug use and suggest the need to reduce PIM use in all racial and ethnic groups.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Raver, E., Jung, J. K., Carlin, C., Feldman, R. D., Retchin, S. M., & Xu, W. (2025). Racial and Ethnic Differences in Potentially Inappropriate Medication Use Among Medicare Beneficiaries. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2025.4763
Vancouver
Raver E, Jung JK, Carlin C, Feldman RD, Retchin SM, Xu W. Racial and Ethnic Differences in Potentially Inappropriate Medication Use Among Medicare Beneficiaries. JAMA Network Open. 2025. doi:10.1001/jamanetworkopen.2025.4763. PMID: 40227682.
BibTeX
@article{raver2025-40227682,
author = {Raver, Eli and Jung, Jeah Kyoungrae and Carlin, Caroline and Feldman, Roger D and Retchin, Sheldon M. and Xu, Wendy},
title = {{Racial and Ethnic Differences in Potentially Inappropriate Medication Use Among Medicare Beneficiaries}},
journal = {JAMA Network Open},
year = {2025},
doi = {10.1001/jamanetworkopen.2025.4763},
pmid = {40227682},
url = {https://doi.org/10.1001/jamanetworkopen.2025.4763}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- The study sample included 21 193 170 patients with 32 199 587 beneficiary-year observations (mean [SD] age, 75.5 [7.3] years; 18 936 697 [58.8%] female; 983 513 [3.1%] Asian or Pacific Islander, 3 190 515 [9.9%] Black, 2 710 930 [8.4%] Hispanic, and 25 314 629 [78.6%] White).
- Compared with White beneficiaries, the rates of high-risk medication use were 1.7 [95% CI, -1.8 to -1.6] percentage points lower for Asian or Pacific Islander beneficiaries, 3.4 [95% CI, -3.4 to -3.3] percentage points lower for Black beneficiaries, and 0.6 [95% CI, -0.6 to -0.5] percentage points lower for Hispanic beneficiaries.
- Similarly, White beneficiaries had the highest rates of potentially harmful drug-disease interactions among those with dementia as well as those with a history of falls.
- The pattern of racial and ethnic differences was similar in analyses stratified by enrollment in TM or MA plans.
- However, the differences between White individuals and other groups were smaller in MA than in TM plans for all comparisons.
Why it matters
White Medicare beneficiaries had consistently higher rates of potentially inappropriate medication use and harmful drug-disease interactions than other racial and ethnic groups, including among those with dementia. This concerns medication safety and prescribing disparities, not treating, curing or preventing Alzheimer's disease.
Study details
- Study designcross-sectional
- Participants21
- Effect size58.8%; 3.1%; 9.9%
- Evidence strengthLow
How this study scored 52/100
Published in a leading specialty journal, and it is a snapshot of people at one point in time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Network Open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 21 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Wendy Xu: h-index 12 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Minnesota: institution h-index 1,568 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40227682) |
| Free to read | 2 / 2 | Free to read |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/jamanetworkopen.2025.4763
- PubMed: 40227682
- Original source →
- Free full text: JAMA Network Open →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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