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Indicator Metadata

NameAverage Number of Drug Classes Used by Seniors on Public Drug Programs
Short/Other Names

Not applicable

Description

This indicator measures the average number of distinct drug classes (as defined by WHO ATC classification level 4) with at least one claim accepted by a public drug program for a senior (age 65 and older).

Notes

WHO: World Health Organization

ATC: Anatomical Therapeutic Chemical

InterpretationThe indicator measures the average number of drug classes seniors take over the course of a year. Seniors with multiple chronic conditions often require treatment with multiple medications. Using a higher number of drugs is associated with a higher risk of adverse drug reactions and other adverse events, like drug interactions. As some drugs are taken consistently over long periods of time and some (such as antibiotics) are taken for shorter durations, this indicator should not be interpreted as the number of drugs seniors take at one time.
HSP Framework Dimension

Health System Outputs: Appropriate and effective

Areas of Need

Living With Illness, Disability or Reduced Function

Geographic Coverage

Newfoundland and Labrador, Prince Edward Island, New Brunswick, Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia

Reporting Level/Disaggregation

Province/Territory

Indicator Results

https://secure.cihi.ca/estore/productFamily.htm?pf=PFC2594&lang=en&media=0

Identifying Information
NameAverage Number of Drug Classes Used by Seniors on Public Drug Programs
Short/Other Names

Not applicable

Indicator Description and Calculation
Description

This indicator measures the average number of distinct drug classes (as defined by WHO ATC classification level 4) with at least one claim accepted by a public drug program for a senior (age 65 and older).

Notes

WHO: World Health Organization

ATC: Anatomical Therapeutic Chemical

Calculation: DescriptionThe total number of distinct drug classes for each senior (age 65 and older), summed for all seniors on public drug programs, divided by the number of seniors with at least one claim accepted by a public drug program over a defined period (usually one year)
Calculation: Geographic Assignment

Place of service

Calculation: Type of Measurement

Average or mean

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable
Standard Population:
Not applicable

Denominator

Description:
Total number of seniors with at least one claim accepted by a public drug program
Inclusions:
1. All seniors (age 65 years and older)
Exclusions:
1. All non-seniors (age younger than 65 years)

Numerator

Description:
Number of distinct drug classes (as defined by WHO ATC classification level 4) with at least one claim accepted by a public drug program for a senior, summed for all seniors on public drug programs
Inclusions:
1. All seniors (age 65 years and older)
Exclusions:
1. All non-seniors (age younger than 65 years)

Background, Interpretation and Benchmarks
Rationale

Using a higher number of drugs is associated with a higher risk of adverse drug reactions and other adverse events, like drug interactions.

Drug class was selected rather than drug to avoid the impact of seniors switching between drugs for the same condition (it is unlikely that two drugs from the same class would be used at the same time).

This indicator can be used to see whether the average number of drugs a senior is using changes over time and whether there are different prescribing patterns as seniors age.

Interpretation

The indicator measures the average number of drug classes seniors take over the course of a year. Seniors with multiple chronic conditions often require treatment with multiple medications. Using a higher number of drugs is associated with a higher risk of adverse drug reactions and other adverse events, like drug interactions. As some drugs are taken consistently over long periods of time and some (such as antibiotics) are taken for shorter durations, this indicator should not be interpreted as the number of drugs seniors take at one time.

HSP Framework Dimension

Health System Outputs: Appropriate and effective

Areas of Need

Living With Illness, Disability or Reduced Function

Targets/Benchmarks

Not applicable

References

Not applicable

Availability of Data Sources and Results
Data Sources

NPDUIS Database

Available Data Years

Type of Year:
Calendar
First Available Year:
2000
Last Available Year:
2012

Geographic Coverage

Newfoundland and Labrador, Prince Edward Island, New Brunswick, Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia

Reporting Level/Disaggregation

Province/Territory

Result Updates
Update Frequency

Whenever it is required for analytical product or data request

Indicator Results

Web Tool:
CIHI's eStore: Drug Use Among Seniors on Public Drug Programs in Canada, 2012
URL: https://secure.cihi.ca/estore/productFamily.htm?pf=PFC2594&lang=en&media=0

Updates

Not applicable

Quality Statement
Caveats and Limitations

The National Prescription Drug Utilization Information System (NPDUIS) Database includes claims accepted by public drug programs, either for reimbursement or toward a deductible. Claims are included regardless of whether or not the patient actually used the drugs.

The NPDUIS Database does not include information regarding

– Prescriptions that were written but never dispensed

– Prescriptions that were dispensed but for which the associated drug costs were not submitted to or accepted by the public drug programs

– Diagnoses or conditions for which prescriptions were written

The NPDUIS Database contains claims data from public drug programs in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland and Labrador. The First Nations and Inuit Health Branch (FNIHB), a federal drug program, also submits data, which comes from all Canadian provinces and territories (including those not listed above).

Trending Issues

All data is not available for all years:

– Manitoba, Saskatchewan, Alberta, New Brunswick: From January 2000

– Nova Scotia: From April 2001

– Prince Edward Island: From April 2004

– British Columbia: From January 2006

– Newfoundland and Labrador: From April 2008

– Ontario: From April 2010

– First Nations and Inuit Health Branch: From October 2010

Comments

Not applicable