Primary language and medication use: a pan-Canadian population-level retrospective study of home care health administrative data

Studies have identified language-based differences in the quality and safety of care in Canada. This suggests that language could be relevant to broader patterns of health care access and quality, including medication use. This study used pan-Canadian anonymized, population-level home care data collected between January 1, 2010 and March 31, 2023 to examine the relationship between primary language, polypharmacy and hyper-polypharmacy across jurisdictions. Most reported English as their primary language (86.5%), while 1.6% reporting French and 11.9% reported it as “other”. Most home care clients met the criteria for polypharmacy (79.5%) and just under half for hyper-polypharmacy (46.0%). Logistic regression models that controlled for demographic (age, sex) and clinical (cognitive function, communication, pain, health instability, depression, disease diagnoses, and multimorbidity) characteristics revealed that, compared to English, those who reported French as their primary language had increased odds of polypharmacy and hyper-polypharmacy, whereas those who reported “other” as primary language had decreased odds of both outcomes. Examination of this relationship in different jurisdictions across the country revealed no consistent patterns of association. Further studies examining health outcomes and service utilization within home care as well as in other settings among linguistic groups in different regions across Canada is warranted.