Montreal, QC, Canada: Montreal Health and Social Services Agency. Published in French; also have English translation.
Montreal Health and Social Services Agency, Montreal, QC, Canada
This report describes the use of prescription drugs among Montrealers of 65 and more. Analyses were performed using data from the RAMQ, which found all orders of persons covered by Medicare. The study includes Montrealers aged 65 and over, not housed CHLSDs, who had at least one prescription (215 694) recorded in the bank in 2005 – 2006. During 2005-2006, Montrealers aged 65 and over have led to drug spending in the public system, to 413.7 million, an average of $1918 per person. The average number of prescriptions per person (including renewals) is 66 and the median is 46.The biggest users who represent 15% of the study population generate over 40% of drug expenditures. There was even a small subset of very heavy users (about 3500 people) who have an average annual expenditure of more than $12 000. About two thirds (64%) of the total cost of prescriptions can be found in three categories of drugs: cardiovascular system (38%), gastrointestinal tract and metabolism (14%) and central nervous system (12%).The number of different drugs that people take in the same year is very important. Indeed, nearly 2 out of 3 people (62.9%) took at least six different drugs in the year, and nearly one in three (29.8) has taken ten or more. Multivariate analysis indicated that the number of different specialties consulted is the factor most strongly associated with being a major user of drugs and the risk of taking several different medications. People who saw, in the year, six or more different specialties, are eight times more risk (OR = 8.0) for taking at least ten different drugs than those who did not seen by medical specialists, even when controlling for the level of comorbidity in persons. This phenomenon indicates a lack of coordination between different stakeholders and / or gaps in the overall management of the medication by a doctor. Finally, there are significant variations in drug use between populations of 12 countries in Montreal. These variations are partly explained by differences in population characteristics (in particular the structure age).