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Indicator Metadata

NamePotentially Inappropriate Medication Prescribed to Seniors
Short/Other Names

Percentage Rate of Beers Drug Use Among Seniors on Public Drug Programs

DescriptionThe rate of seniors who have a claim from the Beers list (American Geriatrics Society [AGS] 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults)
Interpretation

This indicator is interpreted as the rate of seniors who take a medication identified as potentially inappropriate to prescribe to seniors because it is either ineffective or it poses unnecessarily high risk for older persons and a safer alternative is available. It should be noted that there may be cases where it is appropriate for seniors to take drugs on the Beers list.

There may be differences in population characteristics (such as age and health status) between seniors with and without public coverage. In provinces where a lower proportion of seniors have claims accepted by the public plan, drug utilization patterns among those with public coverage are more likely to be affected by these differences and, therefore, may be less reflective of utilization patterns among all seniors in the province.

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

Accessing Indicator Results on Your Health System: In Depth

Identifying Information
NamePotentially Inappropriate Medication Prescribed to Seniors
Short/Other Names

Percentage Rate of Beers Drug Use Among Seniors on Public Drug Programs

Indicator Description and Calculation
DescriptionThe rate of seniors who have a claim from the Beers list (American Geriatrics Society [AGS] 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults)
Calculation: Description

The total number of seniors with at least one claim for a drug from the Beers list that was accepted by a public drug program divided by the total number of seniors with at least one claim for any drug accepted by a public drug program

Unit of Analysis: Patients

Calculation: Geographic Assignment

Place of service

Calculation: Type of Measurement

Percentage or proportion

Calculation: Adjustment Applied

Age-sex-adjusted

Calculation: Method of Adjustment

Direct Standardization
Standard Population:
Canadian senior population (Statistics Canada, Demography Division, CANSIM table)

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:
2. All non-seniors (age younger than 65 years)

Numerator

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

2. Seniors without a claim from the Beers list

Background, Interpretation and Benchmarks
Rationale

Seniors are at greater risk for adverse drug reactions (ADRs) as well as other types of drug-related adverse events due to the number of drugs they take, the higher prevalence of certain chronic conditions and age-related changes in the body. The higher prevalence of chronic conditions does contribute to the number of drugs seniors take. However, it is important to evaluate the appropriateness of each medication prescribed.

The Beers list is an internationally recognized list of drugs identified as potentially inappropriate to prescribe to seniors because they are ineffective, they pose unnecessarily high risk for older persons or a safer alternative is available.

Interpretation

This indicator is interpreted as the rate of seniors who take a medication identified as potentially inappropriate to prescribe to seniors because it is either ineffective or it poses unnecessarily high risk for older persons and a safer alternative is available. It should be noted that there may be cases where it is appropriate for seniors to take drugs on the Beers list.

There may be differences in population characteristics (such as age and health status) between seniors with and without public coverage. In provinces where a lower proportion of seniors have claims accepted by the public plan, drug utilization patterns among those with public coverage are more likely to be affected by these differences and, therefore, may be less reflective of utilization patterns among all seniors in the province.

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:
Fiscal
First Available Year:
2005
Last Available Year:
2014

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 required for analytical product or data request

Indicator Results

Web Tool:
Your Health System: In Depth
URL:
Accessing Indicator Results on Your Health System: In Depth

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 not 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

Results for this indicator are also available on