What we know now

 

Canadians are often prescribed multiple medications

  • In 2012, nearly two-thirds (65.9%) of seniors had claims for 5 or more drug classes under public drug programs, and more than one-quarter (27.2%) claimed 10 or more[1]

  • 39.3% of Canadians age 85+ take 10 or more medications[2]

  • 60.9% of Canadian seniors living in long-term care homes took 10 or more medications, compared to 26.1% living in the community[3]

 

Drug program spending continues to grow in Canada

  • In 2013, Canadians spent an estimated $34.5 billion on drugs, the majority of which (85.0%) was spent on prescribed drugs, at an estimated $29.3 billion[4]

  • Prescribed drugs accounted for an estimated 13.9% of total health expenditures[5]

  • About 68% of $4.4 billion spent in Canada in 2012 on public drug programs was on seniors age 65+[6]

 

Canadian seniors are often prescribed potentially inappropriate medications

  • In 2012, almost one-quarter of Canadian seniors on public drug programs used one potentially inappropriate medication from the Beers list and over 5% used multiple potentially inappropriate medications[7]

  • Almost one-in-ten seniors age 65+ on a public drug program was prescribed Lorazepam, a benzodiazepine, for anxiety, the most commonly prescribed drug on the Beers list of potentially inappropriate prescriptions due to the associated risk of falls and other adverse events[8]

 

Primary care practitioners prescribe the most and often have questions

  • Primary care practitioners prescribe about 85% of all prescription medications in Canada

  • A recent study found that clinicians raised 0.57 questions per patient seen and, of these questions, 34% were related to medication treatment[9]

  • A secondary analysis of the “Just-in-Time” information librarian consultation service database of questions asked by physicians, 52% of questions related to therapy; of these, 70.7% addressed questions about drug therapy, representing 37% of all questions[10].

 

Medication-related adverse health events cost us billions every year

  • Almost one-quarter of adverse events that patients present with in hospital are related to medication errors, according to the 2004 Adverse Events Study[11]

  • The cost to our health system per adverse health event related to medication use is over $4,000 with the total cost estimated at $400 million per year[12]

Prescription drug abuse as a public health crisis

  • Addiction is a potential side effect of prescription medication use; especially relating to the use of opioids (used to treat pain), benzodiazepines (used to treat anxiety and sleep disorders), and stimulants (used to treat attention deficit disorder)[13]

  • In 2012, 410,000 Canadians reported abusing prescription drugs like opioid pain relievers[14]

  • In 2015[15], over 80,000 Canadian teenagers used prescription drugs to get high[16]

  • Fentanyl, a synthetic opioid medication used to treat pain, has drawn national attention in the past year due to the number of overdose deaths reported across Canada[17]

  • To promote the safe and effective use of opioid treatment for chronic non-cancer pain, researchers at the Michael G. DeGroote National Pain Centre recently published The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain, which updated the 2010 guideline using funding from Health Canada[18]

[1] CIHI (2014). Page 9. Drug Use Among Seniors on Public Drug Programs in Canada, 2012. Accessed May 26, 2017 from: https://secure.cihi.ca/free_products/Drug_Use_in_Seniors_on_Public_Drug_Programs_2012_EN_web.pdf

[2] Ibid.

[3] Ibid, pg. 10.

[4] CIHI (2014). Page vii. Prescribed Drug Spending in Canada, 2012: A Focus on Public Drug Programs. Accessed may 29, 2017 from: https://secure.cihi.ca/free_products/Prescribed_Drug_Spending_in_Canada_EN.pdf

[5] Ibid.

[6] CIHI (2014). Page 12. Drug Use Among Seniors on Public Drug Programs in Canada, 2012. Accessed May 26, 2017 from: https://secure.cihi.ca/free_products/Drug_Use_in_Seniors_on_Public_Drug_Programs_2012_EN_web.pdf

[7] Ibid, pg. 9

[8] Ibid, pg. 27.

[9] Del Fiol et al (2013).

[10] Bjerre et al (2013).

[11] Baker et al (2004). The Canadian Adverse Events Study: the incidence

of adverse events among hospital patients in Canada. Journal of the Canadian Medical Association. 25 MAI 2004; 170 (11). Accessed July 5, 2017 from: http://www.cmaj.ca/content/170/11/1678.full.pdf+html

[12] Canadian Patient Safety Institute. Acessed July 5, 2017 from: http://www.patientsafetyinstitute.ca/en/toolsResources/Research/commissionedResearch/EconomicsofPatientSafety/Pages/default.aspx

[13] Government of Canada (2016). About prescription drug abuse. Web page. Accessed May 26, 2017 from: https://www.canada.ca/en/health-canada/services/substance-abuse/prescription-drug-abuse/about-prescription-drug-abuse.html

[14] Ibid.

[15] TBC

[16] Ibid.

[17] See, for example: http://www.cbc.ca/news/canada/ottawa/fentanyl-crisis-ottawa-mayor-national-strategy-1.3945136

[18] Busse et al (2017). Accessed June 26, 2017 from : http://nationalpaincentre.mcmaster.ca/documents/Opioid%20GL%20for%20CMAJ_01may2017.pdf

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