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Many Manitoba seniors taking improper drugs

Residents in long-term care facilities facing elevated risks

Most seniors in Manitoba -- as well as the rest of the country -- are on five or more medications at any one time.

And the report containing that finding, compiled by the Canadian Institute for Health Information, also found seniors who are living in long-term care facilities are medicated more than those living in the community -- often with drugs they likely shouldn't be on.

The CIHI study, using figures submitted in 2012 by provincial pharmaceutical drug plans in eight provinces including Manitoba, as well as the federal drug program administered by the First Nations and Inuit Health Branch, was released on Thursday. The CIHI was created by the federal, provincial and territorial governments as a not-for-profit, independent organization to collect and analyze information on health and health care in Canada.

'Does it surprise me that seniors take a lot of drugs? No, not at all'

-- Prof. Verena Menec, director of the University of Manitoba's Centre on Aging


The No. 1 drugs used by seniors in Manitoba? Statins, drugs that combat high cholesterol. It's used by 39.8 per cent of seniors using drugs.

Second on the list? Drugs to reduce high blood pressure, heart failure and angina are used by 25.2 per cent of seniors using drugs.

Senior men, aged 65 and up, account for 44 per cent of seniors in Manitoba and claim 43.5 per cent of drugs.

Senior women, aged 65 and up, account for 56 per cent of seniors in Manitoba and claim 56.5 per cent of drugs.

By the time Manitoba seniors get to 85 years and above, they represent 16.2 per cent of seniors and make 17 per cent of drug claims.

Across the country, seniors 65 and older represent 15 per cent of the population, but account for 40 per cent of all spending on prescribed drugs and 60 per cent of public drug program spending

Public drug program spending for seniors in the nine jurisdictions studied tallied $4.4 billion in 2012.


-- source: Canadian Institute for Health Information

The study found 65.9 per cent of seniors claimed the costs of five or more drugs, while 27.2 per cent claimed 10 or more drugs.

"Does it surprise me that seniors take a lot of drugs? No, not at all," said Prof. Verena Menec, director of the University of Manitoba's Centre on Aging.

"A large part of it is that as people get older they have more health problems. If an 80-year-old is on a lot of drugs, that doesn't surprise me. But I'd like to know what they are on and if they interact with each other."

The study found the most commonly used drug by seniors, at 46.6 per cent, were statins, the drugs used to treat high cholesterol.

But Menec said what's interesting is the study found 46.5 per cent of seniors living in long-term care facilities were taking drugs from what's known as the Beers list. It's a list of potentially inappropriate drugs to prescribe to seniors developed by Dr. Mark Beers in 1991, and updated by the American Geriatrics Society in 2012, because there's an elevated risk of adverse effects.

The CIHI study found that's more than twice the rate of the seniors taking the drugs who live in the community (21.3 per cent).

The top prescribed drug, at 17.4 per cent, from the Beers list is lorazepam which is OK to be prescribed for treating anxiety, but not for insomnia, agitation or delirium because it brings a higher risk of cognitive impairment and falls. Six of the top 10 drugs on the Beers list are psychotropic drugs used to treat conditions ranging from depression to insomnia.

"The statistics on inappropriate prescription drug use suggests the need for pharmacist and physician review of medications given to seniors," she said.

"There's a sense there is too much being taken."

Jordan Hunt, the CIHI's manager of pharmaceuticals, said two-thirds of seniors across the country are taking five or more drugs. The CIHI study represents 70 per cent of seniors in Canada.

"The reason is because of the health and age of the population," Hunt said.

"Six of 10 of the most commonly used drugs are for cardiovascular conditions, including high blood pressure"

Hunt said an earlier study by the CIHI in 2010 didn't look at whether seniors were taking drugs on the Beers list.

"Beers-list drugs are potentially inappropriate for seniors. There might be a safer alternative," he said.

Overall, Hunt said the use of drugs by Manitoba seniors is "just above the average rate."

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