[Overview of the use of potentially inappropriate medications among community-dwelling individuals living with major neurocognitive disorders in Québec between 2014 and 2024]
Daigle JM, Rousseau MP
Record ID 32018015892
French
Original Title:
Portrait de l’usage de médicaments potentiellement inappropriés chez les personnes atteintes d’un trouble neurocognitif majeur vivant dans la communauté au Québec entre 2014 et 2024
Authors' objectives:
INESSS was mandated to develop a provincial portrait of the use of
potentially inappropriate medications (PIMs) among community-dwelling individuals aged
65 years and older living with MNCDs in Québec. This portrait may serve as a foundation
for the development of clinical tools aimed at the deprescribing of potentially
inappropriate medications in this population.
Authors' results and conclusions:
RESULTS (#1 APPROXIMATELY HALF OF COMMUNITY-DWELLING INDIVIDUALS AGED 65 YEARS AND OLDER
WITH MNCDS RECEIVED AN ACHEI, AN ALZHEIMER’S DISEASE MEDICATION, DURING THE
YEAR FOLLOWING THEIR MNCD DIAGNOSIS): The Québec cohort of community-dwelling individuals aged 65 years and older with a
diagnosis of MNCD has grown over the past decade, in line with provincial demographic
growth. The mean age of the 2023–2024 cohort was 82 years, and approximately half of
individuals had ten or more medical conditions. (#2 DESPITE A DOWNWARD TREND, THE USE OF PIMS REMAINS HIGH, AFFECTING NEARLY HALF OF
THE COHORT WITH MNCDS IN 2023. ANTIPSYCHOTIC USE REMAINED STABLE OVER TIME): In 2023, among incident MNCD cases, the proportion of individuals who received an
antipsychotic increased from 15.8% prior to MNCD diagnosis to 26.2% following
diagnosis. Antipsychotic use was higher among prevalent MNCD cases (approximately
one in three individuals) compared with incident cases. (#3 ALTHOUGH MEDICATION DOSAGES AND DOSE-REDUCTION EFFORTS WERE NOT EXAMINED, A
MAJORITY OF INDIVIDUALS IN THE COHORT WERE EXPOSED TO PIMS FOR MORE THAN THREE
MONTHS WITHIN A GIVEN YEAR, AND TREATMENT PERSISTENCE WITH POTENTIALLY
INAPPROPRIATE MEDICATIONS WAS HIGH): Among individuals who received at least one PIM, 83% of prevalent cases had access to
at least one PIM for more than three months. More than half of prevalent MNCD cases
had access to at least one PIM throughout the year, with a proportion of days covered
(PDC) greater than 95%. CONCLUSION: In Québec, a majority of community-dwelling individuals diagnosed with MNCDs are
exposed to potentially inappropriate medications, and consequently to potential adverse
drug events and drug interactions.
Authors' methods:
This work is based on a literature review covering publications up to June 2024, which
identified potentially inappropriate medications in the context of major neurocognitive
disorders. In addition, a review of clinical practice guidelines made it possible to identify
recommendations regarding the duration of use of these medications, as well as the
specific conditions under which their use may be considered appropriate.
Details
Project Status:
Completed
Year Published:
2026
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Neurocognitive Disorders
- Dementia
- Alzheimer Disease
- Lewy Body Disease
- Aged
- Aged, 80 and over
- Medication Review
- Deprescriptions
- Inappropriate Prescribing
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.