Gillmeyer KR, Rinne ST, Glickman ME, et al. - Researchers used a retrospective cohort of 34,775 Medicare-eligible veterans with group 2/3 pulmonary hypertension (PH), to determine the factors related to prescribing of phosphodiesterase-5 inhibitors (PDE5i) for group 2/3 PH, especially, to examine the hypothesis that there would be an increased risk of subsequently receiving potentially inappropriate treatment in Veterans Health Administration (VA) among veterans prescribed PDE5i for PH in the community (through Medicare). Backing the primary hypothesis, prior treatment through Medicare was revealed as the variable that was most strongly related to PDE5i treatment in VA for group 2/3 PH. Other variables, such as more severe disease as indicated by recent right heart failure or respiratory failure and prior right heart catheterization, were shown to have a strong link with increased probability of VA treatment. These data are indicative of a missed opportunity to reevaluate treatment suitability when PH patients seek prescriptions from VA, this finding holds relevance given policies encouraging shared care across VA and community settings. There is a necessity for interventions to strengthen awareness that group 2/3 PH patients are unlikely to be benefited with pulmonary vasodilators and rather these agents may induce harmful impacts in these patients.