MOST AMERICANS TAKE MEDICATION WEEKLY; MANY TAKE MULTIPLE PRODUCTS
MOST AMERICANS TAKE MEDICATION WEEKLY; MANY TAKE MULTIPLE PRODUCTS
Concurrent Use of Prescription Drugs and Herbal Supplements Raises Concerns About Unintended Interactions
CHICAGO—In any given week, most US adults take at least 1 medication, and 1 in 6 patients taking prescription drugs also use herbal products or other natural supplements, posing potential risks of adverse interactions, according to an article in the January 16 issue of the Journal of the American Medical Association (JAMA).
David W. Kaufman, ScD, and colleagues at the Slone Epidemiology Unit, Boston University School of Public Health, analyzed data from an ongoing telephone survey to provide recent population-based information on the use of all medications in the United States—including prescription and over-the-counter drugs, vitamins and minerals, and herbal preparations and other natural supplements.
According to background information cited in the article, drug expenditures have increased dramatically in recent years. New prescription drugs are continually introduced and older drugs are increasingly available over-the counter (OTC), making self-medication commonplace. At the same time, there has been a considerable increase in the use of herbal products and other natural supplements, which are not subject to regulation by the Food and Drug Administration (FDA). With rapidly increasing medical care costs, concerns are growing about the benefits and risks of a wide range of prescription and OTC medications. But little comprehensive information is available on exposure to the full range of medication use in the general population.
This study uses data from an ongoing telephone survey of a random sample of noninstitutionalized individuals in the 48 continental states and the District of Columbia. The authors analyzed data from interviews conducted in 1998 and 1999, and compared participants' demographic information with data from US Census projections for 1998 and 2000.
"Among 2590 participants aged at least 18 years, 81% used at least 1 medication in the preceding week; 50% took at least 1 prescription drug; and 7% took 5 or more," they report. "The highest overall prevalence of medication use was among women aged at least 65 years, of whom 12% took at least 10 medications and 23% took at least 5 prescription drugs [and 94% had taken at least 1 medication]."
Among FDA-regulated drugs, OTC analgesics (pain relievers such as acetaminophen, ibuprofen, or aspirin) were the most frequently used individual products, taken by 17% to 23% of the population. Conjugated estrogens and thyroid supplements were the most common prescription drugs among women, while cardiovascular drugs and diuretics were the most common prescription drugs among men.
"Herbals/supplements were taken by 14% of the population," the authors report. "Among prescription drug users, 16% also took an herbal/supplement; the rate of concurrent use was highest for fluoxetine [an antidepressant drug] users, at 22%. The substantial overlap between use of prescription medications and herbals/supplements raises concern about unintended interactions," the authors write.
"Reasons for drug use varied widely, with hypertension [high blood pressure] and headache mentioned most often (9% for each)," they write. "Vitamins/minerals were frequently used for nonspecific reasons such as 'health' (35%); herbals/supplements were also most commonly used for 'health' (16%)."
"Identification of usage patterns for the full
range of medications, including the reasons for
use, provides a basis for improving safety and
reducing risks associated with their
consumption," the authors conclude.
(JAMA. 2002;287:337-344)
Editor's Note: The collection and analysis of the survey data were supported by the Slone Epidemiology Unit. Over the past 5 years, activities of the unit have received major support from the following pharmaceutical manufacturers: Aventis Pharmaceuticals Inc, Bridgewater, NJ, Bayer AG, Wuppertal, Germany, Celgene Corporation, Warren, NJ, GlaxoSmithKline, Research Triangle Park, NC, F Hoffmann-La Roche Ltd, Basel, Switzerland, McNeil Consumer Healthcare, Guelph, Ontario, Novartis AG, Basel, Pfizer Inc, New York, NY, The Procter & Gamble Co, Cincinnati, Ohio, and Whitehall-Robins Healthcare, Madison, NJ.
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