title: Impact of residence on prevalence and intensity of prescription drug use among older adults.
abstract: BACKGROUND
  Higher levels of morbidity among older adults result in greater need for pharmaceutical products and pharmacy services compared with the need in the general population. Rural residents reportedly have reduced access to healthcare services secondary to transportation difficulties, a limited supply of healthcare workers and facilities, and financial constraints.
  
  
  OBJECTIVE
  To examine differences in the prevalence and intensity of prescription pharmaceutical use among urban and rural older adults in Manitoba, Canada.
  
  
  METHODS
  Participant data from the 1996/1997 Manitoba Study of Health and Aging were linked to pharmaceutical claims data recorded in Manitoba Health's Drug Program Information Network. The effect of residence on the prevalence and intensity of drug use was determined, in addition to the effects of other sociodemographic characteristics, measures of health, and health service utilization.
  
  
  RESULTS
  The prevalence of prescription pharmaceutical use did not differ between urban and rural residents (90.6% vs 89.5%, respectively; p = 0.60). Users of home-care services (OR 1.93; 95% CI 1.09 to 3.39), those who perceived their income as adequate (2.38; 95% CI 1.09 to 5.17), and those with a higher number of chronic health problems (1.42; 95% CI 1.26 to 1.62) were significantly more likely to access prescription medications. Rural and urban residents were equally likely to be high users of prescription drugs (21.3% vs 20.0%, respectively; p = 0.64).
  
  
  CONCLUSIONS
  Poor health status is associated with a higher prevalence and intensity of use of prescription drugs among older Manitobans. Rural residence is not a barrier to receipt of prescription pharmaceuticals.
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada. acarrie@pharmacy.ualberta.ca
authors.forename: Anita G
authors.initials: AG
authors.lastname: Carrie
authors.forename: Ruby E
authors.initials: RE
authors.lastname: Grymonpre
authors.forename: Audrey A
authors.initials: AA
authors.lastname: Blandford
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008350:Manitoba; D004364:Pharmaceutical Preparations; D015995:Prevalence; D012424:Rural Population / Q000639:trends; D014505:Urban Population / Q000639:trends
chemical_list: D004364:Pharmaceutical Preparations