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Percentage Rate of Beers Drug Use Among Seniors on Public Drug Programs
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Description
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The rate of seniors who have a claim from the Beers list (an internationally recognized list of drugs that are identified as potentially inappropriate to prescribe to seniors due to an elevated risk of adverse effects)
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Interpretation
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This indicator is interpreted as the rate of seniors who take a medication identified as potentially inappropriate to prescribe to seniors because they "are either ineffective or they pose 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.
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HSP Framework Dimension
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Health System Outputs: Appropriate and effective

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Areas of Need
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Living With Illness, Disability or Reduced Function

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Geographic Coverage
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Prince Edward Island, New Brunswick, Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta

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Reporting Level/Disaggregation
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Province/Territory

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Latest Result Update Date
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4/2009

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Indicator Results
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e-publications: Drug Claims by Seniors: An Analysis Focusing on Potentially Inappropriate Use of Medications, 2000–2006 (https://secure.cihi.ca/estore/productSeries.htm?locale=en&pc=PCC454) and Health Care in Canada, 2011: A Focus on Seniors and Aging (https://secure.cihi.ca/estore/productFamily.htm?pf=PFC1677&lang=en&media=0)

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Identifying Information
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Name
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Percentage Rate of Beers Drug Use Among Seniors on Public Drug Programs
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Short/Other Names
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Not Applicable

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Indicator Description and Calculation
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Description
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The rate of seniors who have a claim from the Beers list (an internationally recognized list of drugs that are identified as potentially inappropriate to prescribe to seniors due to an elevated risk of adverse effects)
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Calculation: Description
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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

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Place of service

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Calculation: Type of Measurement
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Percentage or proportion

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Calculation: Adjustment Applied
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Age-sex-adjusted

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Calculation: Method of Adjustment
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Direct Standardization
Standard Population:
Canadian Senior Population (Statistics Canada, Demography Division, CANSIM table)

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Denominator
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Description:
Total number of seniors with at least one claim accepted by a public drug program
Inclusions:
1. All seniors (age in years greater than or equal to 65)
Exclusions:
2. All non-seniors (age in years less than 65)

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Numerator
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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 in years greater than or equal to 65) with at least one claim for a drug from the Beers list
Exclusions:
1. All non-seniors (age in years less than 65)

2. Seniors without a claim from the Beers list

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Background, Interpretation and Benchmarks
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Rationale
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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 either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available."

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Interpretation
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This indicator is interpreted as the rate of seniors who take a medication identified as potentially inappropriate to prescribe to seniors because they "are either ineffective or they pose 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.

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HSP Framework Dimension
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Health System Outputs: Appropriate and effective

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Areas of Need
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Living With Illness, Disability or Reduced Function

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Targets/Benchmarks
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Not Applicable

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References
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Not Applicable

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Availability of Data Sources and Results
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Data Sources
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NPDUIS Database

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Available Data Years
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Type of Year:
Calendar
First Available Year:
2000
Last Available Year:
Ongoing

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Geographic Coverage
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Prince Edward Island, New Brunswick, Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta

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Reporting Level/Disaggregation
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Province/Territory

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Result Updates
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Update Frequency
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Whenever required for analytical product or data request

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Latest Result Update Date
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4/2009

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Indicator Results
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Web Tool:


URL:
e-publications: Drug Claims by Seniors: An Analysis Focusing on Potentially Inappropriate Use of Medications, 2000–2006 (https://secure.cihi.ca/estore/productSeries.htm?locale=en&pc=PCC454) and Health Care in Canada, 2011: A Focus on Seniors and Aging (https://secure.cihi.ca/estore/productFamily.htm?pf=PFC1677&lang=en&media=0)

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Updates
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Not Applicable

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Quality Statement
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Caveats and Limitations
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The 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, or diagnoses or conditions for which prescriptions were written.

The NPDUIS Database contains claims data from public drug programs in Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, Nova Scotia and Prince Edward Island. 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).

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Trending Issues
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All data is not available for all years:

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

– Nova Scotia: From April 2001

– P.E.I.: From April 2004

– Ontario: From April 2010

– First Nations and Inuit Health Branch: From October 2010

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Comments
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Not Applicable