Table 3.
Comparison of underuse, overuse, and misuse in 1999 to 2009
| 1999 | 2009 | ||
|---|---|---|---|
| % (95% CI) | % (95% CI) | P value | |
| Underuse Measures Group | |||
| Antithrombotic therapy for AF | 45.9 (33.4 – 59.0) | 71.9 (66.5 – 76.7) | <.01 |
| ACE Inhibitor use for CHF | 44.8 (37.6 – 52.4) | 41.6 (37.4 – 45.9) | .47 |
| Aspirin use for CAD | 28.4 (22.4-35.3) | 64.5 (60.2-68.5) | <.01 |
| BB in CHF | 20.6 (11.8 – 33.4) | 59.7 (53.8 – 65.4) | <.01 |
| BB in CAD | 28.1 (22.1 – 35.2) | 55.2 (51.7 – 58.8) | <.01 |
| Anti-platelet use for stroke | 51.0 (36.7 – 65.2) | 48.7 (41.1 – 56.3) | .78 |
| Statin in CAD | 26.8 (19.7 – 35.2) | 58.6 (54.1 – 63.0) | <.01 |
| Statin in DM | 12.1 (9.23 – 15.57) | 36.2 (33.4 – 39.2) | <.01 |
| Pharmacologic therapy for osteoporosis | 35.3 (23.6 – 48.9) | 45.1 (37.8 – 52.7) | .21 |
| Overuse Measures Group | |||
| Prostate cancer screening in men age > 74 | 3.5 (2.4 – 5.1) | 5.7 (4.6 – 7.0) | .03 |
| Screening EKG in adults in GME | 6.1 (3.1 – 11.5) | 11.3 (5.9 – 20.8) | .20 |
| Screening UA in adults in GME | 39.9 (29.5 – 51.4) | 25.3 (17.2 – 35.6) | .05 |
| Screening Xray in adults in GME | 4.7 (2.4 – 9.1) | 7.0 (3.2 – 14.5) | .47 |
| Screening CBC in adults in GME | 22.3 (13.1 – 35.3) | 37.9 (26.8 – 50.6) | .08 |
| Cervical cancer screening in women age> 65 | 3.1 (2.6 – 3.8) | 2.2 (1.8 – 2.7) | .02 |
| Mammography screening for women age >74 | 2.1 (1.5 – 3.0) | 2.6 (2.0 – 3.5) | .35 |
| Imaging for back pain in adults age >18 | 19.1 (15.2 – 24.1) | 22.8 (18.4 – 27.9) | .25 |
| Abx for URI | 37.8 (34.4-41.3) | 40.2 (36.6-43.9) | .36 |
| Abx for acute bronchitis | 60.8 (51.4 – 69.5) | 58.8 (47.3 – 69.4) | .78 |
| Abx for asthma | 22.3 (13.9 – 33.9) | 6.8 (4.9 – 9.3) | .001 |
| Misuse Measures Group | |||
| Abx other than Nitrofurantoin/Trimethoprim/Quinolone use for UTI | 24.9 (18.1 – 33.2) | 2.7 (1.2 – 5.7) | <.01 |
| Inappropriate meds in the elderly | 6.5 (5.8 – 7.3) | 7.2 (6.3 – 8.1) | 0.29 |