By Julie Bortolotti
It isn’t surprising to hear that as people get older, they require prescription medication to help address medical conditions associated with aging. But, a new report found that many of Canada’s seniors are being prescribed a lot of drugs. About 1 in 4 seniors are prescribed 10 or more drugs, according to a report from the Canadian Institute for Health Information (CIHI).
CIHI’s report showed that the number of drugs prescribed to seniors hasn’t changed significantly since 2011. However, several initiatives appear to have been successful in reducing the use of some prescription drugs, including antipsychotics (used to treat schizophrenia and bipolar disorder) and benzodiazepines (used for anxiety and insomnia).
Drugs used to treat high cholesterol — used by nearly half of all seniors — were the most commonly prescribed drug class. Other common drug classes prescribed among seniors included drugs for acid reflux disease, peptic ulcer disease and high blood pressure.
Who is prescribed the most drugs?
The number of drugs prescribed increases with age. In 2016, about 21 per cent of seniors age 65 to 74 had claims for 10 or more drugs, compared to about 38 per cent of seniors age 85 and older.
Seniors who are women, live in a rural area or a low-income area are also more likely to take more drugs. There are several factors that may explain these findings. Women tend to have more chronic conditions, they seek out more preventive care than men do, and they live longer than men, on average. Seniors in low-income neighbourhoods could take more drugs due to differences in health status by income. For example, Canadians with the lowest income were twice as likely to report living with cardiovascular disease than those with the highest income. Experts suggest the difference is rural and urban drug use could be because people who live in rural areas may have less access to resources, including care providers and alternative treatment options.
More drugs = more hospital visits
Seniors who were prescribed 10+ drugs were more likely to be hospitalized for an adverse drug reaction — over 5 times more likely than seniors who were prescribed fewer drugs. An adverse drug reaction could include falls, fractures and mental impairment. Cancer drugs, opioids and blood thinners were the most common drug classes that led to hospitalizations for adverse drug reactions.
Because seniors need to take multiple drugs to manage their conditions, regular medication reviews with a pharmacists and/or physician can help reduce the risk of an adverse drug reaction.
Potentially inappropriate drugs can also increase the risk of adverse effects and there are often safer alternatives. Commonly used drug classes such as proton pump inhibitors (used for acid reflux disease and peptic ulcer disease) and benzodiazepines are among the drugs considered to be potentially inappropriate under certain circumstances.
“Physicians want people to feel their best as they age and that often involves many prescription drugs,” said Jeff Proulx, program lead of Pharmaceuticals at the Canadian Institute for Health Information. “We hope our report creates awareness around seniors’ drug use. We want seniors and their families feel encouraged to talk to their pharmacist or physician about their medications.”
Julie Bortolotti is a Communications Specialist at The Canadian Institute for Health Information (CIHI).