Medication errors are among the most common medical mistakes, harming at least 1.5 million people every year.

Medication errors occur commonly in the elderly population and among Medicare beneficiaries across all medical settings. Causes of inappropriate medication use are numerous and may include poor care coordination among multiple physicians in fragmented community health care environments. The persistence and high prevalence of potentially inappropriate medication (PIM) and potential drug-drug interactions (DDI) in the Medicare population support the need for quality improvement projects to improve drug safety.

The Carolinas Center for Medical Excellence (CCME), under our current quality improvement organization (QIO) contract with the Centers for Medicare & Medicaid Services (CMS), analyzed Medicare Part D prescription drug claims data to calculate state and county level rates of PIM and DDI.

The DDI and PIM indicators, limited to eligible Medicare enrollees receiving prescription drug coverage under Medicare Part D, are intended to provide a feasibly determined measure for the purposes of quality improvement monitoring and evaluation. Analyses of the data provide CCME and other stakeholders information to focus intervention efforts.

DDI and PIM rates vary across the Carolinas

For claims from July 2007 through December 2007:

• In North Carolina, DDI rates range from 6.3% in Hyde County to 12.8% in Mitchell County. PIM rates range from 14.5% in Orange County to 32.9% in Robeson County.
• South Carolina DDI rates range from 6.7% in Calhoun County to 12.3% in Allendale County. PIM rates range from 16.9% in Beaufort County to 32% in Bamberg County.
• DDI rates are highest among whites and females in both states.

Drug Safety Measures in the Carolinas Medicare Population

CCME developed this Drug Safety Measures website to facilitate the reduction of DDI and PIM events across the Carolinas. Distribution maps allow users to see statewide variations in DDI and PIM rates. Demographic tables allow users to view and compare rates within groups (Age, Race and Sex) and across counties or regions. Providers, plans , and educators may utilize the reports to identify areas on which to focus educational efforts.

(Click image to reach that section of the website)

	Select Single County View to display the rates for a single county or region and the statewide summary.
	Select Multiple County View to display rates for all the counties in a region or to select up to 10 counties.
	Select Help to review frequently asked questions, including detailed specifications for the measures and helpful hints for navigating the site.

For more information about Drug Safety, visit our Patient Safety Resources page. We welcome questions and comments. Please contact us at DrugSafety@thecarolinascenter.org.