Potentially risky prescriptions are the leading cause of hospitalizations for one in two seniors across Canada, according to an analysis of data from the Canadian Institute of Health Information (CIHI) report.

More elderly persons are living longer than ever before, and the healthcare system buckles in effort to not only provide the proper care, but prevent unnecessary harm to Canada’s aging population.

“Medication errors occur all the time,” said Jennifer Jin, a pharmacist at the Queensway Carleton Hospital in Ottawa, Ontario. “The result can be clinically insignificant to fatal, depending on the medication involved.”

Between 2015 and 2016, upwards of four million seniors aged 65 and older were admitted to a Canadian hospital, according to numbers in the CIHI report. 1.9 million of them were admitted because of either wrong or potentially harmful medication.

A medication error can happen at any point before the prescription reaches the patient.

It can be as simple as an incorrectly written administration route, a wrong dosage supplied, or a prescription picked up from the wrong tray.

“There’s not one nurse that can say ‘I’ve never done a medication error,’” said Guylaine Gallant, the director of health and wellness at the Prince of Wales Manor in Barrhaven, a retirement home in Ottawa.

“It does happen,” she said. “But we try to make sure that there are no room for errors.”

Hospitalizations put a strain on the healthcare system, especially when it can be prevented.

“The hospital beds would ideally be available for patients who need care due to their medical conditions,” said Jin. “And not filled with patients who have iatrogenic illnesses from taking wrong or inappropriate medications.”

The terms ‘inappropriately prescribed’ and ‘potentially inappropriate’ have completely different meanings, she noted. The latter refers to unsafe prescriptions for the elderly population that should be avoided altogether.

The Institute for Safe Medication Practices Canada’s ‘Beers List’ compiled medication names, cases and research for potentially inappropriate medications for older persons. Listed as ‘high alert’ are: warfarin, oral antiplatelet, insulin, opioids and digoxin – all medications used for blood clotting and blood sugar regulation, narcotics or various cardiovascular problems.

In Jin’s experience, the top three prescriptions given to partients are heart medications, antidepressants and narcotics. All of which are commonly used by seniors as well.

While the Canadian Institute for Health Information report doesn’t show for which inappropriate medications are most frequently used or administered by who, healthcare professionals have systems in place to prevent risks and errors from happening.

Gallant oversees the Manor’s implementations of the College of Nurses of Ontario standards to ensure mistakes and risks are minimized. Some examples include operating their own in-house pharmacy, a self-reporting system for errors and numerous trainings and audits per year.

“It’s like CPR. You think you now it until you’re being asked at a course and think, ‘s**t, is the ratio 50 to two? Thirty to five?’” Gallant said, highlighting the importance of  accountability in her line of work. “It’s the same with medication—you get a little comfortable and you forget some stuff.”

On the other side of the counter, another problem occurs. When a patient sees multiple doctors, specialists a locations, they don’t bring their medical history slip and ends up on serious medications, this is known as ‘poli-pharmacy’.

“It’s huge. Next thing you know, this medication interacts with that one— but the physician didn’t know—  the patient is 80,” ,” Gallant said. “She can’t tell she’s already on that medication. They end up having so much medication and that’s why they’re in the hospital.”

“The aging population is getting too much,” she said, stressing the need for for better care. “I just feel the need for them is here.”