{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:52:38Z","timestamp":1787849558614,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,21]],"date-time":"2014-01-21T00:00:00Z","timestamp":1390262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["P30 AG024827"],"award-info":[{"award-number":["P30 AG024827"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["K07AG033174"],"award-info":[{"award-number":["K07AG033174"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["R01AG027017"],"award-info":[{"award-number":["R01AG027017"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["R01HS018721"],"award-info":[{"award-number":["R01HS018721"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Veterans Affairs Health Services Research and Development Service Career Development Award","award":["CDA 09-207"],"award-info":[{"award-number":["CDA 09-207"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To assess the association between multiple pharmacy use and medication adherence and potential drug\u2013drug interactions (\n                      <jats:styled-content style=\"fixed-case\">DDI<\/jats:styled-content>\n                      s) in older adults.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional propensity score\u2010weighted analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>2009 claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A nationally representative sample of 926,956 Medicare Part D beneficiaries aged 65 and older continuously enrolled in fee\u2010for\u2010service Medicare and Part D that year who filled one or more prescriptions at a community retail or mail order pharmacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Multiple pharmacy use was defined as concurrent (overlapping time periods) or sequential use (non\u2010overlapping time periods) of \u22652 pharmacies in the year. Medication adherence was calculated using a proportion of days covered of 0.80 or greater for eight therapeutic categories (beta\u2010blockers, renin angiotensin system antagonists, calcium channel blockers, statins, sulfonylureas, biguanides (metformin), thiazolidinediones, and dipeptidyl peptidase\u2010\n                      <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n                      inhibitors). Potential\n                      <jats:styled-content style=\"fixed-case\">DDI<\/jats:styled-content>\n                      s arising from use of certain drugs across a broad set of classes were defined as the concurrent filling of two interacting drugs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 38.1% of the sample used multiple pharmacies. Those using multiple pharmacies (concurrently or sequentially) consistently had higher adjusted odds of nonadherence (ranging from 1.10 to 1.31,\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a0.001) across all chronic medication classes assessed after controlling for sociodemographic, health status, and access to care factors than single pharmacy users. The adjusted predicted probability of exposure to a\n                      <jats:styled-content style=\"fixed-case\">DDI<\/jats:styled-content>\n                      was also slightly higher for those using multiple pharmacies concurrently (3.6%) than for single pharmacy users (3.2%, adjusted odds ratio (\n                      <jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content>\n                      )\u00a0=\u00a01.11, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      )\u00a0=\u00a01.08\u20131.15) but lower in individuals using multiple pharmacies sequentially (2.8%,\n                      <jats:styled-content style=\"fixed-case\">AOR<\/jats:styled-content>\n                      \u00a0=\u00a00.85, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a00.81\u20130.91).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Filling prescriptions at multiple pharmacies was associated with lower medication adherence across multiple chronic medications and a small but statistically significant greater likelihood of\n                      <jats:styled-content style=\"fixed-case\">DDI<\/jats:styled-content>\n                      s in concurrent pharmacy users.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.12645","type":"journal-article","created":{"date-parts":[[2014,1,21]],"date-time":"2014-01-21T15:18:37Z","timestamp":1390317517000},"page":"244-252","source":"Crossref","is-referenced-by-count":51,"title":["Effect of Multiple Pharmacy Use on Medication Adherence and Drug\u2013Drug Interactions in Older Adults with Medicare Part D"],"prefix":"10.1111","volume":"62","author":[{"given":"Zachary A.","family":"Marcum","sequence":"first","affiliation":[{"name":"Division of Geriatric Medicine University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Driessen","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Graduate School of Public Health University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn T.","family":"Thorpe","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Therapeutics School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania"},{"name":"Veterans Affairs Pittsburgh Healthcare System Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid F.","family":"Gellad","sequence":"additional","affiliation":[{"name":"Veterans Affairs Pittsburgh Healthcare System Pittsburgh Pennsylvania"},{"name":"Department of General Internal Medicine School of Medicine University of Pittsburgh Pittsburgh Pennsylvania"},{"name":"RAND Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Donohue","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Graduate School of Public Health University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.892"},{"key":"e_1_2_7_3_1","unstructured":"Slone Epidemiology Center.Patterns of Medication Use in the United States [on\u2010line]. 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