Age and sex patterns of drug prescribing in a defined American population.

OBJECTIVE To describe the age and sex patterns of drug prescribing in Olmsted County, Minnesota. PATIENTS AND METHODS Population-based drug prescription records for the Olmsted County population in 2009 were obtained using the Rochester Epidemiology Project medical records linkage system (n=142,377). Drug prescriptions were classified using RxNorm codes and were grouped using the National Drug File-Reference Terminology. RESULTS Overall, 68.1% of the population (n=96,953) received a prescription from at least 1 drug group, 51.6% (n=73,501) received prescriptions from 2 or more groups, and 21.2% (n=30,218) received prescriptions from 5 or more groups. The most commonly prescribed drug groups in the entire population were penicillins and β-lactam antimicrobials (17%; n=23,734), antidepressants (13%; n=18,028), opioid analgesics (12%; n=16,954), antilipemic agents (11%; n=16,082), and vaccines/toxoids (11%; n=15,918). However, prescribing patterns differed by age and sex. Vaccines/toxoids, penicillins and β-lactam antimicrobials, and antiasthmatic drugs were most commonly prescribed in persons younger than 19 years. Antidepressants and opioid analgesics were most commonly prescribed in young and middle-aged adults. Cardiovascular drugs were most commonly prescribed in older adults. Women received more prescriptions than men for several drug groups, in particular for antidepressants. For several drug groups, use increased with advancing age. CONCLUSION This study provides valuable baseline information for future studies of drug utilization and drug-related outcomes in this population.

[1]  B. Yawn,et al.  Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project. , 2012, Mayo Clinic proceedings.

[2]  D. Malone,et al.  Gender and age differences in medications dispensed from a national chain drugstore. , 2008, Journal of women's health.

[3]  D. Kennedy,et al.  Prescription Drug Use in 1984 and Changes Over Time , 1988, Medical care.

[4]  Joshua Lederberg,et al.  Microbial Threats to Health: Emergence, Detection, and Response , 2003 .

[5]  C. Roe,et al.  Gender- and Age-Related Prescription Drug Use Patterns , 2002, The Annals of pharmacotherapy.

[6]  Troy C. Blanchard,et al.  Correlating pharmaceutical data with a national health survey as a proxy for estimating rural population health , 2010, Population health metrics.

[7]  W. Courtenay.  Constructions of masculinity and their influence on men's well-being: a theory of gender and health. , 2000, Social science & medicine.

[8]  B. Yawn,et al.  American Journal of Epidemiology Practice of Epidemiology Use of a Medical Records Linkage System to Enumerate a Dynamic Population over Time: the Rochester Epidemiology Project , 2022 .

[9]  Grant T. Baldwin,et al.  CDC grand rounds , 2012 .

[10]  Scott M. Brue,et al.  Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system. , 2012, International journal of epidemiology.

[11]  E. Kokmen,et al.  Incidence of dementia and Alzheimer's disease: a reanalysis of data from Rochester, Minnesota, 1975-1984. , 1998, American journal of epidemiology.

[12]  Jon O Ebbert,et al.  Why patients visit their doctors: assessing the most prevalent conditions in a defined American population. , 2013, Mayo Clinic proceedings.

[13]  B. Yawn,et al.  History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population. , 2012, Mayo Clinic proceedings.

[14]  Anne Elixhauser,et al.  Medication-Related Adverse Outcomes in U.S. Hospitals and Emergency Departments, 2008 , 2011 .

[15]  Vicki L Burt,et al.  Prescription drug use continues to increase: U.S. prescription drug data for 2007-2008. , 2010, NCHS data brief.

[16]  Russell S. Kirby,et al.  The Dartmouth Atlas of Health Care , 1998 .

[17]  A. Mitchell,et al.  Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. , 2002, JAMA.

[18]  R. Lipton,et al.  Migraine: Epidemiology, Impact, and Risk Factors for Progression , 2005, Headache.

[19]  B. Lambert,et al.  Frequency estimates from prescription drug datasets (revision of #04‐11‐066A) , 2006, Pharmacoepidemiology and drug safety.

[20]  Z. Wiesenfeld‐Hallin,et al.  Sex differences in pain perception. , 2005, Gender medicine.

[21]  Christopher G. Chute,et al.  Analyzing categorical information in two publicly available drug terminologies: RxNorm and NDF-RT , 2010, J. Am. Medical Informatics Assoc..

[22]  A. Sommer,et al.  Getting What We Deserve: Health and Medical Care in America , 2009 .

[23]  Use of chronic medications among a large, commercially‐insured US population , 2002, Pharmacoepidemiology and drug safety.

[24]  M. Olfson,et al.  National patterns in antidepressant medication treatment. , 2009, Archives of general psychiatry.

[25]  A. Mitchell,et al.  Prevalence and characteristics of opioid use in the US adult population , 2008, PAIN.

[26]  Christopher G Chute,et al.  Using RxNorm and NDF-RT to classify medication data extracted from electronic health records: experiences from the Rochester Epidemiology Project. , 2011, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[27]  Vital signs: prevalence, treatment, and control of high levels of low-density lipoprotein cholesterol--United States, 1999-2002 and 2005-200. , 2011, MMWR. Morbidity and mortality weekly report.

[28]  M. Wallander,et al.  Prescription Drug Use, Diagnoses, and Healthcare Utilization among the Elderly , 2001, The Annals of pharmacotherapy.

[29]  D. Kennedy,et al.  Drug use and expenditures in 1982. , 1985, JAMA.

[30]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2012 update: a report from the American Heart Association. , 2012, Circulation.

[31]  L. Simoni-Wastila,et al.  Differences in prescription drug utilization and expenditures between Blacks and Whites in the Georgia Medicaid population. , 1998, Inquiry : a journal of medical care organization, provision and financing.

[32]  K J Berkley.  Sex differences in pain , 1997, Behavioral and Brain Sciences.

[33]  R. Mojtabai.  Increase in Antidepressant Medication in the US Adult Population between 1990 and 2003 , 2008, Psychotherapy and Psychosomatics.

[34]  M. Zodet,et al.  Implications of the Accuracy of MEPS Prescription Drug Data for Health Services Research , 2011, Inquiry : a journal of medical care organization, provision and financing.

[35]  N. Mantel,et al.  On epidemiologic surveys. , 1983, American journal of epidemiology.

[36]  Christopher M. Jones,et al.  CDC Grand Rounds: Prescription Drug Overdoes - A U.S. Epidemic , 2012 .

[37]  D. Kennedy,et al.  Drug use in the United States in 1981. , 1984, JAMA.

[38]  Mark Olfson,et al.  Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. , 2011, Health affairs.

[39]  E. Mariño,et al.  Identifying how age and gender influence prescription drug use in a primary health care environment in Catalonia, Spain. , 2008, British journal of clinical pharmacology.

[40]  J. Kotzan,et al.  Influence of age, sex, and race on prescription drug use among Georgia Medicaid recipients. , 1989, American journal of hospital pharmacy.

[41]  Current depression among adults---United States, 2006 and 2008. , 2010, MMWR. Morbidity and mortality weekly report.

[42]  K. E. Dixon,et al.  An evaluation of sex differences in psychological and physiological responses to experimentally-induced pain: a path analytic description , 2004, Pain.

[43]  Norman L. Johnson,et al.  New developments in survey sampling , 1970 .

[44]  J. Kennedy,et al.  Unfilled Prescriptions of Medicare Beneficiaries: Prevalence, Reasons, and Types of Medicines Prescribed , 2008, Journal of managed care pharmacy : JMCP.

[45]  B. Stuart,et al.  Patterns of outpatient prescription drug use among Pennsylvania elderly , 1991, Health care financing review.

[46]  Yuting Zhang,et al.  Geographic variation in Medicare drug spending. , 2010, The New England journal of medicine.

[47]  Troy C. Blanchard,et al.  Evaluating Heart Disease Presciptions-Filled as A Proxy for Heart Disease Prevalence Rates , 2008, Journal of health and human services administration.