Study finds too many Quebec seniors being overprescribed inappropriate medications

Georges Marcoux was well on his way up the corporate ladder when he was hit with unbearable stress and anxiety.

When he couldn't sleep, he went to his doctor, and was given 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. Never asked myself, should I stop it?"

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

Marcoux said it wasn't until he started learning more about the side effects of the drug he was taking that he decided he needed to stop. 

"I could fall, I could have problems with driving," he said. "I also had five brothers and sisters that died of Alzheimer's, and I was not going to go that route."

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 are often dealing with multiple ailments at once, and time with their doctor is limited.

"When you're in the doctor's office, there are a lot of time pressures. So it is faster to write a prescription than to explain why we don't necessarily have a solution for the problem in front of us. Sometimes we don't have a good medication option, and so we pick the only option that we have," she said.

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

• Gabapentinoids: an anti-seizure medication
• Proton pump inhibitors: treatment for gastric reflux
• Antipsychotics: used to treat mood and sleep disorders

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

"I think patients really need to be empowered to ask, what are the side effects of this medication? Would it be better if I took no medication at all? Is there a non medication treatment for this?" she said.

She adds that there needs to be more shared decision-making between the prescriber and the patient.

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

McDonald said there's a growing awareness of the problem and more resources to help people quit. Anyone who wants to find out more about the drug they are taking and find support can go to the Canadian Medication Appropriateness and Deprescribing Network website.

Joining a sleep study helped Marcoux get off Oxazepam. He said the process took a year and was challenging, but he's not only feeling better, but now he's sleeping better, too.