CFN Funded ProjectsProducts
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| Risk factors for dementia development, frailty, and mortality in older adults with epilepsy – A population-based analysisThe final draft of the article describing this analysis of the CALIBER data is complete and will be submitted to Epilepsia very shortly.CAT2017-19 University of Calgary Department of Clinical Neurosciences, University of Calgary | Publication | 2020-08-10 | | | Frailty and unintended risks of medications. Frailty and unintended risks of medications.
Part of Journal Topical Collection on Epidemiology of AgingCAT2017-21 University of Calgary, University of Waterloo | Publication | 2020-04-07 | | | Frailty, drug use and hospitalization among older assisted living residentsPoster presentation, 3rd Annual TVN Conference on improving care for frail elderly Canadians, Toronto, ON, Sept 27-29, 2015.SIG2014-M1 University of Calgary, ICES (Institute for Clincial Evaluative Sciences), Mt. Sinai Hospital, St. Michael's Hospital, University of Waterloo | Publication | 2015-09-27 | | | The coexistence of frailty, dementia and depression in older adultsPoster presentation, 3rd Annual TVN Conference on improving care for frail elderly Canadians, Toronto, ON, Sept 27-29, 2015.SIG2014-M1 University of Calgary, ICES (Institute for Clincial Evaluative Sciences), University of Waterloo | Publication | 2015-09-27 | | | The identification of frailty and its role as an effect modifier of adverse drug-related outcomes among assisted living residents. Stock K, Hogan DB, Tyas S, Bronskill SE, Morris AM, Bell CM, Jeffs L, Maxwell CJ. The identification
of frailty and its role as an effect modifier of adverse drug-related outcomes among assisted living
residents.
Oral presentation, 44th Annual Scientific & Educational Meeting, Canadian Association on
Gerontology, Calgary, AB, Oct 23-25, 2015.
Abstract published in C J Aging
SIG2014-M1 University of Calgary, ICES (Institute for Clincial Evaluative Sciences), Mt. Sinai Hospital, St. Michael's Hospital, University of Waterloo | Publication | 2015-10-23 | | | Antipsychotic use and hospitalization among older assisted living residents: Does risk vary by frailty status? There is emerging interest regarding whether an assessment of frailty may help to better differentiate both the potential risks as well as benefits of medications in older adults. We showed that two different approaches to defining frailty (the frailty index and physical phenotype) showed similar findings in modifying the risk of hospitalization associated with prevalent antipsychotic use among older Assisted Living residents. Not only was risk elevated among frail antipsychotic users, hospitalization risk was significantly lower for users of antipsychotics among non-frail residents.SIG2014-M1 University of Calgary, University of Massachusetts, Canadian Institute for Health Information (CIHI), ICES (Institute for Clincial Evaluative Sciences), Mt. Sinai Hospital, St. Michael's Hospital, University of Waterloo | Publication | 2017-07-01 | | | Role of frailty in understanding the risks and benefits of pharmacotherapy in older adultsEvaluative Clinical Sciences Rounds, ICES & Sunnybrook, March 21, 2017, Toronto, ONSIG2014-M1 University of Waterloo, University of Calgary, Canadian Institute for Health Information (CIHI) | Publication | 2017-03-21 | | | Prevalence of, and resident and facility characteristics associated with antipsychotic use in assisted living vs. long-term care facilities: a cross-sectional analysis from Alberta, Canada.Most of the clinical and policy attention directed at reducing antipsychotic use has been focused on the long-term care sector. However, concerns about high rates of antipsychotic use and associated risks of adverse events are clearly important to vulnerable residents of other care settings including assisted living facilities. We showed that potentially inappropriate antipsychotic use was more common among older assisted living vs. long-term care residents and that frailty was a strong predictor for receiving inappropriate antipsyhcotic use. Further, frail residents residing in facilities with relatively poor oversight by clinical and pharmacy staff were at particular risk of inappropriate antipsychotic exposure
2017 Jan;34(1):39-53.SIG2014-M1 Canadian Institute for Health Information (CIHI), University of Massachusetts, University of Calgary, University of Waterloo | Publication | 2017-01-01 | | | Resident and Facility Level Predictors of Antipsychotic Use in Assisted LivingPoster presentation at the 32nd International Conference on Pharmacoepidemiology & Therapeutic Risk Management; August 25-28, 2016, Dublin, Ireland
Abstract published in Pharmacoepidemiology and Drug Safety 2016;25(Suppl. 3):363-4.SIG2014-M1 University of Waterloo, Canadian Institute for Health Information (CIHI), University of Massachusetts, University of Calgary | Publication | 2016-08-25 | | | Exposure to potentially inappropriate medication among long-term care residents with cognitive impairment in Ontario: Is therePoster presentation at Alzheimer’s Association International Conference (AAIC), Toronto, ON, July 24-28, 2016.
Abstract published in Journal of Alzheimer's association 2016;12(7):578SIG2014-M1 University of Waterloo, Queen's University, University of Toronto, University of Calgary, Mt. Sinai Hospital, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2016-07-24 | | | Sex differences in potentially inappropriate medication use and frailty at nursing home transition: a retrospective cohort study. Poster presentation at International Conference on Pharmacoepidemiology (ICPE), Montreal, QC, August 27-30, 2017. SIG2014-M1 University of Waterloo, University of Calgary, University of Massachusetts, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2017-08-27 | | | Prevalence of Prescription and Non-Prescription Polypharmacy by frailty and sex among middle-aged and older CanadiansBackground:
Estimates of polypharmacy have primarily been derived from prescription claims, and less is known about the use of non-prescription medications (alone or in combination with prescription medications) across the frailty spectrum or by sex. Our objectives were to estimate the prevalence of polypharmacy (total, prescription, non-prescription, and concurrent prescription and non-prescription) overall, and by frailty, sex and broad age group.
Data:
Canadian Health Measures Survey, Cycle 5, 2016 to 2017.
Methods:
Among Canadians aged 40 to 79 years, all prescription and non-prescription medications used in the month prior to the survey were documented. Polypharmacy was defined as using five or more medications total (prescription and non-prescription), prescription only and non-prescription only. Concurrent prescription and non-prescription use was defined as two or more and three or more of each. Frailty was defined using a 31-item frailty index (FI) and categorized as nonfrail (FI ≤ 0.1) and pre-frail or frail (FI > 0.1). Survey-weighted descriptive statistics were calculated overall and age standardized.
Results:
We analyzed 2,039 respondents, representing 16,638,026 Canadians (mean age of 56.9 years; 51% female). Overall, 52.4% (95% confidence interval [CI] = 47.3 to 57.4) were defined as pre-frail or frail. Age-standardized estimates of total polypharmacy, prescription polypharmacy and concurrent prescription and non-prescription medication use were significantly higher among pre-frail or frail versus non-frail adults (e.g., total polypharmacy: 64.1% versus 31.8%, respectively). Polypharmacy with non-prescription medications was common overall (20.5% [95% CI = 16.1 to 25.8]) and greater among women, but did not differ significantly by frailty.
Interpretation:
Polypharmacy and concurrent prescription and non-prescription medication use were common among Canadian adults, especially those who were pre-frail or frail. Our findings highlight the importance of considering non-prescribed medications when measuring the exposure to medications and the potential risk for adverse outcomes. CAT2017-21 University of Waterloo, St. Michael's Hospital, University of Calgary, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2022-06-08 | "Daniel Harris ", "Yanling Guo ", Nardine Nakhla, Mina Tadrous, David Hogan, "Deirdre Hennessy ", "Kelly Langlois ", "Rochelle Garner ", Sarah Leslie, Susan Bronskill, George Heckman, Colleen Maxwell | | Frailty and potentially inappropriate medication use at nursing home transitionMany residents with cognitive impairment or dementia enter nursing homes on potentiall inappropriate medications (PIMs). PIMs are more likely to be started in frail individuals following admission. Interventions to support deprescribing of PIMs should be implemented targeting frail individuals during the transition to nursing home.SIG2014-M1 University of Waterloo, Mt. Sinai Hospital, University of Calgary, University of Toronto, Queen's University, St. Michael's Hospital, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2017-10-01 | "LC. Maclagan ", Colleen Maxwell, "S. Gandhi ", "J. Guan ", Chaim Bell, David Hogan, Nick Daneman, Sudeep Gill, Andrew Morris, Lianne Jeffs, "M. Campitelli ", Dallas Seitz, Susan Bronskill | | Pharmacists’ knowledge, perceptions and practices regarding frailty: A cross-sectional survey across practice settings in CanadaFrailty describes the health and resilience of older adults and is associated with risk of adverse drug events, especially related to polypharmacy. We surveyed Canadian pharmacists’ understanding, beliefs, and practices in the assessment of frailty. Integrating frailty into the pharmacists' workup, and the pathway to frailty-based medication interventions are discussed.CAT2017-21 University of Waterloo, St. Michael's Hospital, University of Calgary | Publication | 2023-02-22 | | | Examining the relevance of frailty to cholinesterase inhibitor (ChEI) use and discontinuation during transition to long-term care: a population-based cohort studyAccepted for poster presentation to 2018 International Conference on Promoting Healthy Brain Aging and Preventing Dementia: Research and Translation, June 20-22, 2018, Banff, ABSIG2014-M1 University of Waterloo, University of Massachusetts, University of Calgary, Canadian Institute for Health Information (CIHI), Queen's University, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2018-06-20 | "L. Maglagan ", Colleen Maxwell, "J. Guan ", "M. Campitelli ", "N. Herrmann ", Kate Lapane, David Hogan, Joseph Amuah, Dallas Seitz, Sudeep Gill, Susan Bronskill | | Frailty and other predictors of cholinesterase inhibitor use and discontinuation during transition to nursing home: a population-based cohort studyAccepted for poster presentation to Canadian Association of Health Services & Policy Research (CAHSPR) Conference, May 28-31, 2018, Montreal, QCSIG2014-M1 ICES (Institute for Clincial Evaluative Sciences), University of Massachusetts, University of Calgary, Canadian Institute for Health Information (CIHI), Queen's University, University of Waterloo | Publication | 2018-05-28 | "L. Maclagan ", Susan Bronskill, "J. Guan ", "M. Campitelli ", "N. Herrmann ", Kate Lapane, David Hogan, Joseph Amuah, Dallas Seitz, Sudeep Gill, Colleen Maxwell | | The variation of statin use among nursing home residents and physicians: a cross-sectional analysis. Statin prescribing was substantial within nursing homes, even among frail residents. After controlling for resident characteristics, the prescribing of statins was not randomly distributed across physicians. Further studies are required to evaluate the risks and benefits of statin use, and discontinuation, among nursing home residents to inform clinical practice in this setting.SIG2014-M1 University of Waterloo, Mt. Sinai Hospital, University of Toronto, St. Michael's Hospital, University of Calgary, University of Massachusetts, Queen's University, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2017-09-01 | "M. Campitelli ", Colleen Maxwell, "V. Giannakeas ", Chaim Bell, Nick Daneman, Lianne Jeffs, Andrew Morris, "PC Austin ", David Hogan, "DT Ko ", Kate Lapane, "LC. Maclagan ", Dallas Seitz, Susan Bronskill | | Exposure to potentially inappropriate medication among long-term care residents with cognitive impairment in Ontario: Is there an association with frailty? Oral presentation to Canadian Association for Health Services and Policy Research (CAHSPR), May 9-12, 2016. Toronto, ONSIG2014-M1 University of Waterloo, Queen's University, University of Toronto, University of Calgary, Mt. Sinai Hospital, ICES (Institute for Clincial Evaluative Sciences) | Publication | 2016-05-09 | "L. Maclagan ", "J. Guan ", "S. Gandhi ", Colleen Maxwell, "M. Campitelli ", Sudeep Gill, Nick Daneman, Dallas Seitz, David Hogan, Andrew Morris, Chaim Bell, Susan Bronskill | | Antipsychotic use, frailty and health outcomes among residents of assisted living.Oral presentation at 32rd International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE).
Abstract published in Pharmacoepidemiology and Drug Safety 2016;25(Suppl. 3):263.SIG2014-M1 University of Waterloo, Canadian Institute for Health Information (CIHI), University of Massachusetts, ICES (Institute for Clincial Evaluative Sciences), Mt. Sinai Hospital, St. Michael's Hospital, University of Calgary | Publication | 2016-08-28 | |
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