Prescription Drug Use and Polypharmacy in U.S. Adults

Summary and Comment |
November 5, 2015

Prescription Drug Use and Polypharmacy in U.S. Adults

  1. Thomas L. Schwenk, MD

Nearly 60% of adults took at least one prescription drug during 2011–2012, and 15% took five or more.

  1. Thomas L. Schwenk, MD

Most information about prescription drug use in the U.S. comes from pharmacy or administrative databases. To evaluate prescription drug use on a population level, researchers examined data from the National Health and Nutrition Survey on prescription drug use in 38,000 adults (age, ≥20) assessed during seven 2-year survey cycles (1999–2000 through 2011–2012); data were collected from 5000 to 6000 participants during each cycle.

From 1999 through 2012, the percentage of participants who reported any prescription drug use during the previous 30 days rose from 51% to 59%. The prevalence of polypharmacy (≥5 prescription drugs) rose from 8.2% to 15% overall, and from 24% to 39% in participants 65 and older. Among 18 major drug classes, prevalence of use rose in 11, with particularly large relative increases in use of angiotensin-receptor blockers (from 2.1% to 5.8%), statins (from 6.9% to 17%), serotonin–norepinephrine reuptake inhibitors (from 0.4% to 2.0%), and clopidogrel (from 0.3% to 1.6%). Drugs with notable drops in use included antiarrhythmic agents, prescription antihistamines, cyclooxygenase-2 inhibitors, and postmenopausal hormones. The most commonly prescribed drugs during 2011–2012 included statins (17%), angiotensin-converting–enzyme inhibitors (12%), β-blockers (11%), thiazide diuretics (9.4%), and selective serotonin reuptake inhibitors (8.5%).

Comment

These observations probably confirm the experience of most clinicians. Perhaps the most provocative finding is the dramatic increase in polypharmacy among older patients. Whether that trend is associated with either longer life or improved quality of life is not clear.

Editor Disclosures at Time of Publication

  • Disclosures for Thomas L. Schwenk, MD at time of publication Editorial boards UpToDate

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