Many seniors in Quebec are over-prescribed: study

Georges Marcoux was well on his way to climbing the corporate ladder when he was struck by unbearable stress and anxiety.

When he couldn’t sleep, he went to his doctor and got a prescription for Oxazepam, a benzodiazepine used to treat anxiety.

It helped, and he ended up taking the medication every day for 35 years.

“It was a routine,” he said. “So I never asked myself why. I never asked myself, should I stop?”

He says that over the years, no doctor or pharmacist has ever questioned why he was taking the drug, which can be addictive and increase the risk of accidents.

Marcoux said he only decided he needed to quit when he learned more about the side effects of the drug he was taking.

“I could fall, I could have trouble driving,” he said. “I also had five siblings who died of Alzheimer’s, and I had no intention of going down that path.”

Dr. Emily McDonald, director of the Canadian Medication Appropriateness and Deprescribing Network, said seniors are especially at risk of being prescribed potentially inappropriate medications.

That’s because they often deal with multiple conditions at the same time and time with their doctor is limited.

“When you’re at the doctor, there’s a lot of time pressure. So it’s faster to write a prescription than to explain why we don’t necessarily have a solution to the problem in front of us. Sometimes we don’t.” There is no good medication option, so we choose the only option we have,” she said.

McDonald and her team at the Research Institute at McGill University Health Center (MUHC) studied prescription data collected between 2013 and 2021, and 42 percent of people over age 65 are taking at least one inappropriate medication, which can lead to falls and cognitive impairment . The three most commonly prescribed were:

• Gabapentinoids: an anti-seizure drug
• Proton pump inhibitors: treatment of gastric reflux
• Antipsychotics: Used to treat mood and sleep disorders

She says that while they are effective, many of these medications are not intended to be taken long-term, and as we age, the way we metabolize medications changes.

“I think patients really need to be given the opportunity to ask themselves: What are the side effects of this drug? Would it be better if I didn’t take any medication at all? Is there a non-drug treatment for this?” she said.

She adds that more shared decision-making is needed between the prescriber and the patient.

In January, Quebec’s College of Physicians announced more measures to monitor doctors who may be overprescribing medications such as opioids and benzodiazepines.

McDonald said there is growing awareness of the problem and more resources to help people quit. Anyone who wants to learn more about the medication they are taking and seek help can visit the Canadian Medication Appropriateness and Deprescribing Network website.

Participating in a sleep study helped Marcoux get off Oxazepam. He said the process took a year and was challenging, but not only does he feel better, he now sleeps better too.