Prescription medication usage trends
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Overall Trends in Prescription Medication Usage in the United States
Prescription medication use in the United States has increased significantly over the past two decades. Among adults, the percentage reporting use of any prescription drug rose from 51% in 1999-2000 to 59% in 2011-2012, with polypharmacy (use of five or more prescription drugs) nearly doubling from 8.2% to 15% during the same period Kantor2015Kantor2016. This upward trend persisted even after adjusting for changes in the age distribution of the population . More recent data show that this increase continued through 2015-2016, with usage patterns varying by age, sex, and race/ethnicity .
Polypharmacy and Medication Appropriateness Among Older Adults
Older adults are particularly affected by rising prescription medication use. The median number of prescription medications used by adults aged 65 and older doubled from 2 to 4 between 1988 and 2010, and the proportion taking five or more medications tripled from 12.8% to 39% . From 2011 to 2020, the prevalence of polypharmacy among older adults increased slightly from 39.3% to 43.8% . Despite this, the use of potentially inappropriate medications decreased from 28.2% to 15.1% between 1988 and 2010, but remained high at around 15% in more recent years Pan2024Charlesworth2015. The use of recommended medications for conditions like heart failure and albuminuria remains suboptimal, with less than half of eligible older adults receiving them . Concurrent use of prescription drugs and dietary supplements has also increased, raising the risk of major drug-drug interactions, which affected about 15% of older adults by 2010-2011 .
Trends in Prescription Drug Classes
The increase in prescription drug use is not uniform across all drug classes. Among adults, the use of antihyperlipidemic agents, antidepressants, proton-pump inhibitors, and muscle relaxants has increased significantly Kantor2015Kantor2016. For pain management, opioid prescriptions have declined since 2014, while prescriptions for non-opioid pain medications such as acetaminophen, gabapentinoids, and antidepressants have increased . This shift reflects a move toward CDC-recommended non-opioid pain management strategies .
Prescription Medication Use Among Children and Adolescents
In contrast to adults, prescription medication use among children and adolescents has decreased slightly. The percentage using any prescription medication in the past 30 days dropped from 24.6% in 1999-2002 to 21.9% in 2011-2014 . However, the use of certain medication classes, such as asthma medications, ADHD medications, and contraceptives, has increased, while the use of antibiotics, antihistamines, and upper respiratory combination medications has declined Hales2018Chai2012. Overall, the total number of prescriptions dispensed to children decreased by 7% from 2002 to 2010, while adult prescriptions increased by 22% during the same period .
Conclusion
Prescription medication usage in the United States has risen notably among adults, especially older adults, with a marked increase in polypharmacy and use of specific drug classes such as antihyperlipidemics and antidepressants. While the use of potentially inappropriate medications among older adults has declined, the risk of drug-drug interactions has grown due to increased concurrent use of multiple medications and supplements. Among children and adolescents, overall prescription use has decreased, but there are important shifts in the types of medications used. These trends highlight the need for ongoing monitoring and interventions to ensure the safe and appropriate use of prescription medications across all age groups.
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