Safe Use of Medications - About the Project

The Project aims to raise awareness of safe use practices among caregivers of seniors, and children with chronic illness. It was launched in the fall of 2005, and ends in March 2008. Health Canada is supporting the project through the Drug Strategy Community Initiatives Fund. A National Advisory Panel with experts from across Canada is guiding the Project.

The Project has two components aimed at educating caregivers of seniors and children with chronic illness. For caregivers of seniors, existing educational materials are being adapted. For caregivers of children with chronic illness, an inventory of existing tools is underway. Materials being developed include a resource guide, facilitator manual for workshops, literature review, needs assessment, this website and other resources to support caregivers.

Poor compliance with long-term therapy is a worldwide problem, according to the World Health Organization (WHO).¹ 1. World Health Organization. 2003 Adherence to Long-Term Therapies: Evidence for Action. Geneva: WHO. The results are poor health and increased health care costs.² 2. WHO defines adherence as, “the extent to which a person’s behaviour - taking medication, following diet, and/or executing lifestyle changes - corresponds with agreed recommendations from a health care provider.”

One in five Canadians used prescription medicine such as pain pills, sleeping pills, antidepressants and diet pills in the 1990s. People use more prescription drugs as they age.³ 3. Health Canada. 1995. Canada’s Alcohol and Other Drugs Survey, Preview 1995. Ottawa: Minister of Supply and Services. More recently, medication use has risen as hospital stays have decreased.^4,5 4. Canadian Institute for Health Information. 2003 Health Care in Canada. Ottawa: CIHI.
5. Canadian Institute for Health Information. 2004. Drug Expenditure in Canada 1985-2003. Ottawa: CIHI.

That means more Canadians than ever before who are seriously ill are using medications outside of controlled hospital settings, especially frail seniors and children with chronic illness.

Of necessity, family members (or friends and neighbours) – mostly women – are the main care providers. Access to home care support varies across the country and from community to community. The incidence of hospital admissions and readmissions due to preventable drug-related problems is substantial.⁶ 6. Canadian Institute for Health Information. 2004 Healthcare in Canada. Ottawa, CIHI.

There is a variety of professionals who provide support services, including home support workers, registered nurses, physical therapists, social workers, case managers and community pharmacists.⁷ 7. The Homecare Sector Study Corporation. 2003. Canadian Homecare Human Resources Study: Technical Report. www.homecarestudy.com. Apart from family physicians, these community care providers are often the only source of information for caregivers.

Yet fewer than 10% of such “formal” caregivers have any training in working with “informal” caregivers. This is despite the fact that 76% of caregivers want more information, advice or training on caregiving and community resources.⁸ 8. Ibid.

More than 75% of older Canadians have at least one chronic disease, and 33% have three or more.¹ 1. Williams, I, Rush, D.R. 1986 Geriatric polypharmacy. Hospital Practice (office edition), 21, 109-112. Most seniors living at home are taking medicine, usually two or more kinds a day.² 2. Ibid. Seniors make up 12% of the population, but account for up to 40% of all drugs prescribed.³ 3. Quinn, K.M., Baker, J. & Evans, B. 1992. A population-wide profile of prescription drug use in Saskatchewan. Canadian Medical Association Journal, 146, 2177-2186.

On average, 50% of patients do not take their medicine properly.⁴ 4. Levbovits, A.H., Strain, J.J., Schleifer, S.J., Tanaka, J.S., et al 1990 Patient noncompliancee with self-administered chemotherapy. Cancer, 65, 17-22. Problematic medication use often results in drug-related illnesses, which account for 5 to 23% of hospitalizations.⁵ 5. Grymonpre, R.E., Mitenko, P.A., Sitar, D.S., Aoki, F.Y. et al 1988 Drug-associated hospital admissions in older medical patients. Journal of the American Geriatric Society, 36, 1092-1098. Most problems are accidental and caused by confusion, forgetting or misunderstanding.⁶ 6. Lau, H.S., Beuning, K.S., Postma-lim, E., Klein-Beemimnk, L. et al 1996. Non-compliance in elderly people: Evaluation of risk factors by longitudinal data analysis. Pharmacy World and Science, 18, 63-68.

More than half a million children and youth are living with long-term physical or mental health problems in Canada. Asthma accounts for a large portion of chronic illness among Canadian children.¹ 1. Canadian Council on Social Development. 2006 The Progress of Canada’s Children and Youth 2006.Available at: http://www.ccsd.ca/pccy/2006/. Nearly 7.7% of children and youth are limited in what they can do by a chronic condition.² 2. Canadian Institute of Child Health. 2000. The Health of Canada’s Children. 3^rd ed. Ottawa: CICH. The rates are considerably higher among Aboriginal children and youth: 22% of Aboriginal youth have a disability.³ 3. Hanvey, L. 2002. Children with Disabilities and their Families in Canada. A Discussion Paper. Commissioned for the National Children’s Alliance First Roundtable on Children with Disabilities. Some need complex care; 43% of children with disabilities have conditions considered severe or very severe.⁴ 4. Canadian Council on Social Development. 2006 The Progress of Canada’s Children and Youth 2006.Available at: http://www.ccsd.ca/pccy/2006/.

Among children with disabilities or chronic illness, 41.5% use prescription medicine daily. Medication is taken at least once a week by 10 to 14-year-olds, and regularly by 5 to 9-year-olds.⁵ 5. Canadian Council on Social Development. 2006 The Progress of Canada’s Children and Youth 2006.

For further information about children and medication issues, please see the recent "Synthesis of the Literature" report from the Project.

Definitions

Caregiver

A friend, family member or neighbour who helps someone with daily living or health-related activities. There are many ways to help, such as helping with medicine, recognizing problems and discussing them with a health care professional, picking up prescriptions, arranging for transportation to and from appointments. In some situations caregivers may actually administer medicine, not just supervise or assist. Their attitudes towards and knowledge of the safe use of medicine are very important.

Medicine

Almost anything a person takes to feel better or become healthier. Tablets, capsules, pills, liquids, puffers (inhalers), creams, patches, drops, needles, even vitamins, herbs, ointments, laxatives, aspirin and antacids are all different types of medicine.

Senior

An older adult, used here to refer to a population for whom medicine and caregiving are issues. People react differently to medicine as they age, and older people tend to take more medicine, which means there could be more medicine-related problems.

Chronic Illness

Children with Chronic Illness: Persons under age 18 with a chronic condition or disability who need help from a caregiver.

Chronic Illness: A health condition diagnosed by a health care professional that lasts at least six months. Asthma, juvenile rheumatoid arthritis, acute lymphoblastic leukaemia, cystic fibrosis, epilepsy, allergies and diabetes are common chronic illnesses children develop.