A new study says one in four Canadian seniors is being prescribed ten or more drugs, increasing their chance of being hospitalized for an adverse drug reaction. The Canadian Institute for Health Information (CIHI) says this concurrent use of medications means a senior is five times more likely to be hospitalized than those who were prescribed fewer drugs. The Canadian average is 26.5 per cent of seniors, Alberta is in the middle of the provinces at 22.5 per cent in 2016.
“Seniors are at a higher risk of adverse drug events due to age-related changes in the body and the higher number of drugs they often are taking, compared with younger populations,” explained Jordan Hunt, Manager of Pharmaceuticals at CIHI.
53.4 per cent of Alberta seniors used at least one potentially inappropriate drug in 2016, this is slightly above the Canadian rate of 49.4 per cent.
“This is why assessments are so important,” said Jeff Whissell, Deputy Registrar, Alberta College of Pharmacists.
“Pharmacists are often the most accessible member of an Albertan’s health team and as a result, they may have the opportunity to assess their patients more frequently,” added Jeff. “This fact combined with our expertise regarding appropriate drug use and our expanded scope of practice uniquely positions us to assess our patients to identify, prevent, and resolve drug-related problems.”
Jordan agrees that pharmacists play an important role in managing adverse effects, educating seniors about their medications, and improving compliance with their medications.
“These efforts will continue to be important in the years ahead as the senior population grows.”
Cheryl Sadowski is a professor in the Pharmacy & Pharmaceutical Sciences Faculty at the University of Alberta. She has studied geriatric syndromes over her career.
“The CIHI results are not surprising in that seniors still take on average seven different medications,” Cheryl said. She believes the first step to solving polypharmacy is addressing the tendency to automatically write a prescription.
“There is a cultural expectation to prescribe and it is the expectation that it has to be medications. But we need healthcare professionals to think about non-drug treatments, policies, and reimbursement,” explained Cheryl.
Adverse effects in seniors, from inappropriate drugs, can range from falls, fractures, mental impairment to hospitalization. The study didn’t look at hospitalization by province, but overall 9,573 seniors in six provinces/territories (Alberta, Yukon, Newfoundland and Labrador, PEI, Manitoba, and BC) were hospitalized in 2016.
Seniors are becoming a large segment of a pharmacy practice, given the number of medications they typically are on, and that for the first time in census history there are more seniors than children living in Canada. Jeff feels that the pharmacy is essential to seniors’ health.
“Every pharmacist has the opportunity to make a huge difference in the treatment and quality of life of seniors but none of that is possible without making an assessment every time you provide them prescriptions and care.”
There was a bright spot in the report according to Jordan.
“We did see decreases in the use of benzodiazepine and antipsychotics, particularly in long-term care. These are two classes that have been the focus of targeted initiatives to reduce their use.”
CIHI hopes this report will not only raise awareness, but also identify areas to investigate in the future.