PCV102 - Drug Use Among Seniors On Public Drug Programs In Canada, 2012

Abstract

Seniors take more drugs than younger Canadians because, on average, they have a higher number of chronic conditions. Although taking multiple medications may be necessary to manage these conditions, it is important to consider the benefits and risks of each medication and the therapeutic goals of the patient. This article provides an in-depth look at the number and types of drugs used by seniors using drug claims data from the CIHI’s National Prescription Drug Utilization Information System Database, representing approximately 70% of seniors in Canada. In 2012, almost two-thirds (65.9%) of seniors on public drug programs had claims for five or more drug classes, while 27.2% had claims for 10 or more, and 8.6% had claims for 15 or more. The most commonly used drug class was statins, used by nearly half (46.6%) of seniors. Nearly two-thirds (60.9%) of seniors living in long-term care (LTC) facilities had claims for 10 or more drug classes. Proton pump inhibitors were the most commonly used drug class among seniors living in LTC facilities (used by 37.0% of seniors in LTC facilities), while statins ranked seventh (29.8%). Introduction Seniors take more drugs than younger Canadians because, on average, they have a higher number of chronic conditions (Ramage-Morin 2009; CIHI 2011). Using multiple prescription medications is an important part of managing many of these conditions (CIHI 2011; Terner et al. 2011; Kwan and Farrell 2012). Although taking multiple medications may be necessary to manage these conditions, it is important to consider the benefits and risks of each medication and the therapeutic goals of the patient. This article uses drug claims data from the CIHI’s National Prescription Drug Utilization Information System (NPDUIS) Database to provide an in-depth look at the number and types of drugs used by seniors, and to compare drug use among seniors living in long-term care (LTC) facilities and those living in the community. The NPDUIS Database currently contains claims data from public drug programs in eight Canadian provinces – Prince Edward Island, Nova Scotia, New Brunswick, Ontario, Manitoba, Saskatchewan, Alberta and British Columbia – as well as one federal drug program, managed by the First Nations and Inuit Health Branch. Data include drug claims for approximately 70% of Canadian seniors. How Many Drugs Are Seniors Using? In 2012, almost two-thirds (65.9%) of seniors on public drug programs had claims for five or more drug classes, while 27.2% had claims for 10 or more, and 8.6% had claims for 15 or more. The number of drug classes used by seniors increased with age (Figure 1). In 2012, 42.7% of seniors aged 65–74 had claims for fewer than five drug classes and 20.0% had claims for 10 or more. Among seniors aged 85 and older, 20.5% had claims for fewer than five drug classes, while 39.3% had claims for 10 or more, including 13.2% with claims for 15 or more classes. As seniors age, they tend to use more prescription drugs owing to a higher prevalence of certain chronic conditions (Ramage-Morin 2009; CIHI 2011; Kwan and Farrell 2012). Which Drugs Are Most Commonly Used by Seniors? In 2012, 6 of the 10 most commonly used drug classes among seniors on public drug programs were cardiovascular-related (Table 1). The most commonly used drug class was statins, which are used to lower cholesterol. Nearly half (46.6%) of seniors had at least one claim for a statin in 2012. The next most commonly used drug classes were angiotensin-convertingenzyme inhibitors, used to treat high blood pressure and heart failure, and proton pump inhibitors (PPIs), which are used to treat gastroesophageal reflux and peptic ulcer disease. These were used by 28.2% and 26.9% of seniors, respectively. Statins were the most commonly used drug class in each age group, although the rate of statin use varied with age, from 46.1% among seniors aged 65–74, peaking at 50.9% in seniors aged 75–84 and declining to a low of 39.1% in seniors aged 85 and older. Two drug classes – sulfonamide diuretics (used to treat high CIHI Survey