Prescription medication use trends
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Overall Trends in Prescription Medication Use 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 medications) nearly doubling in the same period . This upward trend has continued, with more recent data showing that the medication burden remains high, especially among older adults 358. The increase in prescription drug use is seen across many drug classes, including antihyperlipidemic agents, antidepressants, and proton-pump inhibitors .
Prescription Medication Use Among Older Adults
Older adults are particularly affected by rising prescription medication use. The proportion of adults aged 65 and older taking five or more medications tripled from 12.8% in 1988 to 39% in 2010 . More recent data show that polypharmacy prevalence among this group increased from 39.3% in 2011-2012 to 43.8% in 2017-2020 . Despite the high medication burden, the use of potentially inappropriate medications has slightly decreased, but the appropriate use of recommended medications for conditions like heart failure has not improved 35. Nonmedical use of prescription drugs, such as opioids and tranquilizers, has also increased among older adults, raising public health concerns .
Prescription Medication Use Among Children and Adolescents
In contrast to adults, prescription medication use among children and adolescents has decreased slightly. The percentage of children using any prescription medication dropped from 24.6% in 1999-2002 to 21.9% in 2011-2014 . However, there have been increases in the use of specific drug classes, such as asthma medications, ADHD medications, and contraceptives, while the use of antibiotics, antihistamines, and pain medications has declined 47. These trends reflect changing clinical guidelines and public health efforts to reduce unnecessary prescriptions in pediatric populations.
Shifts in Specific Drug Classes
Several drug classes have seen notable changes in prescription rates:
- Pain Medications: Opioid prescriptions have declined, while prescriptions for non-opioid pain medications like acetaminophen, antidepressants, and gabapentinoids have increased, reflecting a shift toward CDC-recommended alternatives for pain management .
- Diabetes Medications: Use of diabetes medications, especially metformin and insulin, has increased. Newer drug classes such as DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT2 inhibitors have also seen rising use, while older classes like sulfonylureas and thiazolidinediones have declined .
- Cardioprotective and Antidepressant Medications: There has been a marked increase in the use of statins, antihypertensives, and antidepressants, contributing to the overall rise in polypharmacy, especially among older adults 158.
Demographic Differences in Prescription Medication Use
Prescription drug use varies by age, sex, and race/ethnicity. Non-Hispanic Whites tend to use more prescription medications over their lifetimes compared to other groups, with Hispanics using the least and non-Hispanic Blacks falling in between . Women are also expected to spend more years of their lives taking prescription drugs than men . Socioeconomic status, age, and health status further influence medication use patterns, with higher medication use seen among those with more chronic conditions and lower socioeconomic status 35.
Conclusion
Prescription medication use in the United States has increased overall, especially among adults and older adults, with a growing prevalence of polypharmacy and shifts in the types of medications prescribed. While some improvements have been made in reducing inappropriate medication use, challenges remain in optimizing the quality and appropriateness of prescriptions, particularly for vulnerable populations. Ongoing monitoring and targeted interventions are needed to address the evolving landscape of prescription medication use.
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