CFN Funded ProjectsProducts
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Getting Older? Where you live matters: Regional variations of care in home care and long-term careTake-home message: The noted 2-fold variations in transfer rates from home care or nursing homes between different provinces strongly suggests that system level practice patterns or allocation of resources (under provincial control) have much more of an impact on care than personal choices or disease-related concerns.SIG2014F-31 Centre Hospitalier de l'Université de Montréal (CHUM), McMaster University, University of Waterloo | Publication | 2018-06-01 | | Problems With Advance Care Planning Processes and Practices in Nursing HomesTG2015-15 University of Manitoba, University of Waterloo, University of Calgary, Conestoga College | Publication | 2020-12-01 | Nora Choi, Allan Garland, Clare Ramsey, Jessica Steer, Heather Keller, George Heckman, Vanessa Vucea, Ikdip Bains, Brittany Kroetsch, Patrick Quail, Seema King, Tatiana Oshchepkova, Tatiana Kalashnikova, Veronique Boscart, Michelle Heyer | 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 |
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