Polypharmacy among Older Individuals with COPD: Trends between 2000 and 2015 in Quebec, Canada

Figures & data

Table 1. Characteristics of the Older Adults with COPD in Quebec, Canada, and their Use of Medication between 2000 and 2015.

Characteristics	2000		2005		2010		2015
	N = 68,532		N = 83,927		N = 97,682		N = 117,005
	N	%	N	%	N	%	N	%
Age (mean ± SD)	76.3 ± 6.3		77.1 ± 6.6		77.3 ± 6.9		77.2 ± 7.2
66–75	34,030	49.7	37,233	44.4	43,251	44.3	54,865	46.9
76–85	28,110	41.0	36,946	44.0	41,062	42.0	44,615	38.1
86+	6,392	9.3	9,748	11.6	13,369	13.7	17,525	15.0
Sex
Female	32,922	48.0	43,377	51.7	52,514	53.8	64,326	55.0
Male	35,610	52.0	40,550	48.3	45,168	46.2	52,679	45.0
Co-morbidity (mean ± SD)	3.0 ± 2.3		3.3 ± 2.5		3.4 ± 2.6		3.5 ± 2.7
Asthma	23,347	34.1	35,072	41.8	41,941	42.9	50,009	42.7
Diabetes	13,068	19.1	21,249	25.3	29,602	30.3	37,954	32.4
Heart failure	14,137	20.6	18,820	22.4	21,118	21.6	24,605	21.0
Hypertension	37,327	54.5	58,516	69.7	73,661	75.4	89,681	76.6
Osteoporosis	9,824	14.3	20,306	24.2	29,383	30.1	38,781	33.1
Co-morbidity score [8]^b
0	14,381	21.0	25,090	29.9	32,587	33.4	44,574	38.1
1	909	1.3	1,614	1.9	24,179	24.8	23,983	20.5
2–3	30,375	44.3	31,020	37.0	16,381	16.8	19,018	16.3
4–5	12,161	17.8	13,205	15.7	11,543	11.8	13,204	11.3
6+	10,706	15.6	12,998	15.5	12,992	13.3	16,226	13.9
GP visits (mean ± SD)	0.2 ± 1.0		0.9 ± 2.4		3.0 ± 3.6		3.2 ± 3.4
Hospitalizations (mean ± SD)	0.5 ± 1.0		0.5 ± 0.9		0.4 ± 0.9		0.4 ± 0.9
Medications
Long-acting bronchodilators	12,857	18.7^a	32,705	39.0^a	63,718	64.6^a	81,895	69.6^a
Long-acting beta-agonists	12.857	18.7^a	30,242	36.1^a	49,226	50.2^a	65,491	55.8^a
Long-acting anticholinergics	0	NA	9,868	11.8^a	45,546	45.7^a	47,989	40.5^a
Short-acting bronchodilators	56,121	81.5^a	65,430	77.8^a	69,464	71.3^a	79,159	67.9^a
Inhaled corticosteroids	41,383	60.6^a	40,185	48.0^a	30,692	31.8^a	29,976	26.0^a
Oral corticosteroids	18,696	27.3^a	22,248	26.8^a	27,253	28.2^a	33,800	29.2^a
Methylxantines	10,266	15.0^a	5,799	6.9^a	3,718	3.8^a	2,213	1.9^a
Roflumilast	0	NA	0	NA	0	0^a	284	0.2^a
Antibiotics	38,915	57.3^a	83,927	49.6^a	51,686	53.3^a	60,952	52.2^a
Smoking cessation treatments	2,569	4.5^a	3,221	4.8^a	5,060	6.4^a	6,198	6.3^a
Yearly number of medications
10–14	21,276	30.9^a	26,642	31.5^a	29,913	30.4^a	34,391	29.2^a
15–19	12,809	18.9^a	17,769	20.9^a	23,227	23.1^a	27,704	23.0^a
20+	8,106	12.3^a	13,193	15.8^a	19,868	20.2^a	26,713	22.4^a

^a Denotes age and sex-standardized proportions according to 2001 Quebec population. Due to the population-based nature of the data, no confidence intervals are presented to facilitate reading. Confidence intervals are available on request.

^b Combined Co-morbidity Index of Charlson and Elixhauser [8].

NA: Long-acting anticholinergics were reimbursed from 2002/2003; roflumilast was introduced in 2011 in Canada but is only reimbursed by the public drug plan under specific circumstances which limits its use.

Figure 1. Age- and sex-standardized proportions of older adults with COPD in Quebec, Canada, exposed to three levels of polypharmacy, between 2000 and 2015.

Figure 2. The use of COPD medications by older adults with COPD in Quebec, Canada, between 2000 and 2015. *LABD: Long-acting bronchodilators; SABD: Short-acting bronchodilators

Simard M, Sirois C, Candas B. Validation of the combined comorbidity index of Charlson and Elixhauser to predict 30-day mortality across ICD-9 and ICD-10. Med Care. 2018;56:441–447. doi: 10.1097/MLR.0000000000000905.

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