Trends in Prescription Drug Use Among Adults in the United States From 1999-2012.
Trends in Prescription Drug Use Among Adults in the United States From 1999-2012.
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DOI：
10.1001/jama.2015.13766
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发表时间：
2015-11-03
期刊：
影响因子：
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通讯作者：
Giovannucci EL
中科院分区：
文献类型：
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作者：
Kantor ED;Rehm CD;Haas JS;Chan AT;Giovannucci EL
记录处方药的使用模式，为临床实践和研究提供信息是很重要的。评估居住在美国的成年人使用处方药的趋势。使用来自国家健康和营养检查调查(NHANES)的具有全国代表性的数据来评估处方药使用的时间趋势。参与者包括37,959名年龄在20岁及以上的非住院美国成年人。纳入了7个NHANES周期(1999-2000年至2011-2012年)，每个周期的样本量从4,861至6,212。日历年，由连续的NHANES循环表示。在每个NHANES周期内，对前30天的处方药使用情况进行总体评估，并按药物类别进行评估。评估了各周期的时间趋势。分析被加权以代表美国成年人口。结果显示，1999年至2000年和2011年至2012年期间，美国成年人的处方药总体使用量有所增加，1999年至2000年估计有51%的美国成年人报告使用过任何处方药，2011年至2012年估计有59%的人报告使用过处方药(差异：8%；95%的可信区间：3.8%-12%；P-Trend<；0.001)。多药房(使用≥5处方药)的流行率从1999年至2000年的估计8.2%上升到2011年至2012年的15%(差异：6.6%；95%CI：4.4%-8.2%；p-Trend<；0.001)。随着年龄的调整，这些趋势在统计上仍然显著。在研究期间，超过2.5%的人口在任何时候使用的18种药物中，11种药物的使用率上升，包括抗高脂药、抗抑郁药、处方质子泵抑制剂和肌肉松弛药。在这项具有全国代表性的调查中，观察到处方药和综合药房的总体使用显著增加。在考虑到人口年龄分布的变化后，这些增长持续存在。在大多数但不是所有的药物类别中，处方药的使用率都有所增加。
It is important to document patterns of prescription drug use to inform both clinical practice and research. To evaluate trends in prescription drug use among adults living in the United States. Temporal trends in prescription drug use were evaluated using nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Participants include 37,959 non-institutionalized US adults, aged 20 years and older. Seven NHANES cycles were included (1999–2000 to 2011–2012), and the sample size per cycle ranged from 4,861 to 6,212. Calendar year, as represented by continuous NHANES cycle. Within each NHANES cycle, use of prescription drugs in the prior 30 days was assessed overall and by drug class. Temporal trends across cycles were evaluated. Analyses were weighted to represent the US adult population. Results indicate an increase in overall use of prescription drugs among US adults between 1999–2000 and 2011–2012 with an estimated 51% of US adults reporting use of any prescription drugs in 1999–2000 and an estimated 59% reporting use in 2011–2012 (Difference: 8%; 95% CI: 3.8%–12%; p-trend<0.001). The prevalence of polypharmacy (use of ≥5 prescription drugs) increased from an estimated 8.2% in 1999–2000 to 15% in 2011–2012 (Difference: 6.6%; 95% CI: 4.4%–8.2%; p-trend<0.001). These trends remained statistically significant with age adjustment. Among the 18 drug classes used by more than 2.5% of the population at any point over the study period, the prevalence of use increased in 11 drug classes including antihyperlipidemic agents, antidepressants, prescription proton-pump inhibitors, and muscle relaxants. In this nationally representative survey, significant increases in overall prescription drug use and polypharmacy were observed. These increases persisted after accounting for changes in the age distribution of the population. The prevalence of prescription drug use increased in the majority of, but not all, drug classes.