There are many scientific studies on issues related to medication use
among seniors and the role of their caregivers. Below is selected information
that has been summarized from the scientific literature. References are
given for those interested in learning more about the research.
Seniors and Medication Issues
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.
Medication Use Issues
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.
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