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. 2010 Oct 7:11:75.
doi: 10.1186/1471-2296-11-75.

From pharmaco-therapy to pharmaco-prevention: trends in prescribing to older adults in Ontario, Canada, 1997-2006

Jana M Bajcar  1 , Li Wang, Rahim Moineddin, Jason X Nie, C Shawn Tracy, Ross Eg Upshur
Affiliations

From pharmaco-therapy to pharmaco-prevention: trends in prescribing to older adults in Ontario, Canada, 1997-2006

Jana M Bajcar et al. BMC Fam Pract. .

Abstract

Background: The developed world is undergoing a demographic transition with greater numbers of older adults and higher rates of chronic disease. Most elder care is now provided by primary care physicians, who prescribe the majority of medications taken by these patients. Despite these significant trends, little is known about population-level prescribing patterns to primary care patients aged 65+.

Methods: We conducted a population-based retrospective cohort study to examine 10-year prescribing trends among family physicians providing care to patients aged 65+ in Ontario, Canada.

Results: Both crude number of prescription claims and prescription rates (i.e., claims per person) increased dramatically over the 10-year study period. The greatest change was in prescribing patterns for females aged 85+. Dramatic increases were observed in the prescribing of preventive medications, such as those to prevent osteoporosis (+2,347%) and lipid-lowering agents (+697%). And lastly, the number of unique classes of medications prescribed to older persons has increased, with the proportion of older patients prescribed more than 10 classes of medications almost tripling during the study period.

Conclusions: Prescribing to older adults by family physicians increased substantially during the study period. This raises important concerns regarding quality of care, patient safety, and cost sustainability. It is evident that further research is urgently needed on the health outcomes (both beneficial and harmful) associated with these dramatic increases in prescribing rates.

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Figures

Figure 1
Figure 1
Frequency distribution of number of unique medication classes for older adults aged 65+ in Ontario, Canada, 1997-2006.
Figure 2
Figure 2
Gender differences in prescription claims per person for older adults aged 65+ in Ontario, Canada, 1997-2006.
Figure 3
Figure 3
Age differences in prescription claims per person for older adults aged 65+ in Ontario, Canada, 1997-2006.
See this image and copyright information in PMC

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