Latest patterns of medication use in the U.S.

In 2004, 82 percent of adults and more than 50 percent of children took at least one prescription, over-the-counter (OTC), or herbal/natural medication in any given week, Boston University researchers revealed recently.

These findings are part of an ongoing population-based survey of the full range of medications used in the United States started in 1998 by the Slone Epidemiology Center at Boston University Medical Center. The investigators previously reported on patterns of use in adults in 1998-99.

The researchers found 30 percent of adults had taken at least five medications during the past week. Medication use increased with age and was higher in women than men in every age group, with one exception-- the proportions who took at least 10 medications were similar among persons aged 65 years or older.

While the overall rate of drug use among adults has not increased since 1998-99, there are now more users of multiple drugs and more users of prescription drugs. In 2004, prescription-only drugs were taken by 55 percent of the population, with 11 percent taking at least five in a one-week period. The most common prescription drugs used by women were a thyroid supplement, a cholesterol-lowering drug and a diuretic. Among men, they were a cholesterol-lowering drug and an ACE inhibitor. OTC analgesics (pain remedy) were the most frequently used drugs among adults.

Decongestants, antihistamines and anti-ulcer agents followed analgesics in frequency. Forty percent of the adult population took a vitamin product, mostly multivitamins, and 19 percent had taken herbal/natural products.

In children 18 years and younger, the most frequently used prescription drugs included a bronchodilator, an antihistamine and an antibiotic. The four drugs with the highest use among children were OTC analgesics and cough and cold preparations. Ibuprofen use was particularly common among 12 to 17 year olds. Multivitamins were taken by 20 percent of children, and use was highest in those younger than five years old. Herbal and natural supplement use was uncommon in children.

In addition to describing the wide range of medications that Americans use, the Slone Survey provides information on why the drugs are used. In adults, the stated reason for use was largely dominated by hypertension and other specific medical conditions. In contrast, among children, upper respiratory infection, allergy and headache together accounted for almost half of the reported episodes of drug use.

Despite the fact that billions of dollars are spent each year on drugs in the United States, and adverse reactions to medications are among the leading cause of hospitalizations and deaths, comprehensive information on medication use by the U.S. population has not been available. “We believe the Slone Survey provides an accurate overall picture of medication use that can be extrapolated to the U.S. population and is of critical importance in defining the “what, how and why” of the full spectrum of medication use among U.S. adults and children,” said David Kaufman, ScD, an author of the report and a professor of epidemiology at BU School of Public Health.

The full report can be obtained here.