title: Frequency and cost of potentially inappropriate prescribing for older adults: a cross-sectional study.
abstract: BACKGROUND
  Many medications pose greater health risks when prescribed for older adults, compared with available pharmacologic and nonpharmacologic alternatives. We sought to quantify the frequency and cost of potentially inappropriate prescribing for older women and men in Canada.
  
  
  METHODS
  Using data for 2013 from the National Prescription Drug Utilization Information System database, which contains prescription claims from publicly financed drug plans in all provinces except for Quebec, we identified the frequency of prescribing and cost of potentially inappropriate medications dispensed to provincial drug plan enrollees aged 65 years or more. Potentially inappropriate prescriptions were defined with the use of the American Geriatrics Society's 2012 version of the Beers Criteria for potentially inappropriate medication use in older adults.
  
  
  RESULTS
  For the 6 provinces with relatively complete data coverage (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario and Prince Edward Island), 37% of older people filled 1 or more prescription meeting the Beers Criteria. A higher proportion of women (42%) than men (31%) filled potentially inappropriate prescriptions. The highest rates of prescribing of potentially inappropriate medications were among women aged 85 or more (47%). Benzodiazepines and other hypnotics were the leading contributors to the overall frequency of and sex differences in prescribing of potentially inappropriate drugs among older adults. We estimated that $75 per older Canadian, or $419 million in total, was spent on potentially inappropriate medications outside of hospital settings in 2013.
  
  
  CONCLUSIONS
  Prescribing of potentially inappropriate medications for older adults is common and costly in Canada, especially for women. Multipronged and well-coordinated strategies to reduce the use and cost of potentially inappropriate drugs would likely generate significant health system savings while simultaneously generating major benefits to patient health.
authors.affiliation: School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Canadian Institute for Health Information (Hunt, Rioux, Proulx), Ottawa, Ont.; BC Cancer Agency (Weymann), Canadian Centre for Applied Research in Cancer Control, Vancouver, BC; Departments of Medicine and Pharmacy (Tannenbaum), Université de Montréal, Montréal, Que.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Morgan
authors.affiliation: School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Canadian Institute for Health Information (Hunt, Rioux, Proulx), Ottawa, Ont.; BC Cancer Agency (Weymann), Canadian Centre for Applied Research in Cancer Control, Vancouver, BC; Departments of Medicine and Pharmacy (Tannenbaum), Université de Montréal, Montréal, Que.
authors.forename: Jordan
authors.initials: J
authors.lastname: Hunt
authors.affiliation: School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Canadian Institute for Health Information (Hunt, Rioux, Proulx), Ottawa, Ont.; BC Cancer Agency (Weymann), Canadian Centre for Applied Research in Cancer Control, Vancouver, BC; Departments of Medicine and Pharmacy (Tannenbaum), Université de Montréal, Montréal, Que.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Rioux
authors.affiliation: School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Canadian Institute for Health Information (Hunt, Rioux, Proulx), Ottawa, Ont.; BC Cancer Agency (Weymann), Canadian Centre for Applied Research in Cancer Control, Vancouver, BC; Departments of Medicine and Pharmacy (Tannenbaum), Université de Montréal, Montréal, Que.
authors.forename: Jeffery
authors.initials: J
authors.lastname: Proulx
authors.affiliation: School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Canadian Institute for Health Information (Hunt, Rioux, Proulx), Ottawa, Ont.; BC Cancer Agency (Weymann), Canadian Centre for Applied Research in Cancer Control, Vancouver, BC; Departments of Medicine and Pharmacy (Tannenbaum), Université de Montréal, Montréal, Que.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Weymann
authors.affiliation: School of Population and Public Health (Morgan), University of British Columbia, Vancouver, BC; Canadian Institute for Health Information (Hunt, Rioux, Proulx), Ottawa, Ont.; BC Cancer Agency (Weymann), Canadian Centre for Applied Research in Cancer Control, Vancouver, BC; Departments of Medicine and Pharmacy (Tannenbaum), Université de Montréal, Montréal, Que.
authors.forename: Cara
authors.initials: C
authors.lastname: Tannenbaum