Estimating Life Course Patterns and Years of Life Lived Taking Prescription Drugs

估计生命历程模式和服用处方药的寿命

基本信息

批准号：
10265197
负责人：
Jessica Yu Ho
金额：
$ 8.25万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10265197
关键词：
Adrenergic beta-Antagonists Adult Adverse drug event Adverse event Age Aging American Antipsychotic Agents Attention Birth Calcium Channel Blockers Cardiovascular Agents Categories Chronic Disease Cognitive Data Databases Development Dimensions Drug Interactions Drug Prescriptions Drug usage Elderly Emergency department visit Expectancy Expenditure First Births Health Health Care Costs Health Expenditures Healthcare High Prevalence Hospitalization Impaired cognition Individual Length of Stay Life Life Cycle Stages Life Expectancy Life Table Estimate Life Tables Light Measures Medical Medicare/Medicaid Metabolic Methodology Methods Opioid Analgesics Pattern Personal Satisfaction Pharmaceutical Preparations Polypharmacy Population Quality of life Reporting Research Risk Running Sex Differences Structure Surveys Therapeutic Time United States Vital Statistics Woman aged baby boomer cohort cost experience fall risk high risk human data human mortality innovation interest men mortality novel opioid epidemic prescription opioid programs readmission risk sex trend

项目摘要

PROJECT SUMMARY Prescription drug use has reached historic highs in the United States, with nearly half of all Americans and over 80% of the population aged 60 and older reporting taking prescription drugs in the past 30 days in 2015-2016. Prescription drugs have become a mainstay of medical treatment for an ever expanding array of conditions. Not only are more Americans taking drugs, but they are taking more of them concurrently (polypharmacy) and for longer durations. While prescription drugs have contributed to improvements in health and mortality, these trends in prescription drug use have also prompted concerns related to overprescribing, rising health care costs, adverse drug events, and quality of life impacts. These issues are particularly salient for older adults, who are the largest per capita consumers of prescription drugs. Increasing attention is being paid to the consequences of prescription drug use, particularly in light of the contemporary American opioid epidemic, which was initially driven by the overuse of prescription opioid painkillers. However, there are no existing measures of life course patterns of prescription drug use, including how much of their lives Americans can now expect to spend taking prescription drugs or ages at initiation of sustained prescription drug use. This project will produce those measures leveraging data from the Medical Expenditure Panel Survey (MEPS), a long running, nationally representative survey that collects high quality data on prescription drug use, combined with life tables from the Human Mortality Database (HMD). We will estimate period life tables for prescription drug use using a novel application of Sullivan's method, which is used to estimate health expectancies. We will estimate the number of years Americans can expect to spend taking (and not taking): (1) any prescription drugs; (2) specific types of prescription drugs (i.e., therapeutic drug classes); and (3) numbers of prescription drugs (0, 1, 2, 3, 4, 5+) to capture polypharmacy by age and sex for each year between 1996 and 2017. We are also interested in changing patterns of prescription drug use across birth cohorts. The majority of drugs used to treat chronic disease were developed after 1950; thus, older adults today, unlike their predecessors, are the first birth cohorts of older adults to have experienced decades of sustained prescription drug use over the life course. We implement a methodological innovation that uses Sullivan's method to calculate temporary life expectancy (i.e., the years of life lived spent taking prescription drugs within a specific age range) for birth cohorts. This innovation, which can be extended to many other research questions using multistate methods for cohorts, will allow us to produce similar estimates to those described above of the number of years birth cohorts born between 1927 and 1996 have spent taking any prescription drugs, specific classes of drugs, and specific numbers of prescription drugs. These estimates have important implications for contemporary debates surrounding prescription drug use including overprescribing, spending, polypharmacy, and the risk of experiencing adverse drug events.

项目摘要处方药的使用已达到美国的历史高度，其中几乎一半的美国人在过去30天内，超过80％的60岁及以上报告服用处方药的人口 2015-2016。处方药已成为一系列不断扩展的医疗治疗的中流状况。不仅有更多的美国人吸毒，而且他们同时服用了更多的毒品（多药）和更长的持续时间。处方药有助于改善健康和死亡率，这些处方药物使用的趋势也引起了与处方过度有关的关注，医疗保健费用上升，不良药物事件和生活质量的影响。这些问题特别明显对于老年人，他们是处方药的人均消费者。越来越关注的是支付了处方药的后果，特别是鉴于当代美国阿片类药物流行病，最初是由处方阿片类止痛药的过度使用驱动的。但是，没有处方药使用的现有生活课程模式，包括美国人的生命中的多少现在可以期望花费处方药或年龄来启动处方药的使用。这项目将产生这些措施，从医疗支出小组调查（MEP）中利用数据，长期运行的全国代表性调查，收集有关处方药使用的高质量数据，与人类死亡率数据库（HMD）的寿命表相结合。我们将估计寿命表使用Sullivan方法的新型应用，处方药的使用，该方法用于估计健康期望。我们将估计美国人可以期望花费（而不是服用）的年数：（1）任何处方药；（2）处方药的特定类型（即治疗药物类别）；（3）数字处方药（0、1、2、3、4、5+）以每年的年龄和性别捕获一年和2017年。我们也有兴趣改变出生队列中的处方药使用模式。这大多数用于治疗慢性疾病的药物是在1950年后开发的。因此，今天的老年人与他们不同前任是老年人的第一个出生队列，经历了数十年的持续处方在生活过程中使用毒品。我们实施了一种方法学创新，该创新使用Sullivan的方法来计算暂时的预期寿命（即，在特定的情况下服用处方药的生命的生活年份年龄范围）出生队列。这项创新可以扩展到许多其他研究问题队列的多态方法将使我们能够产生与上面描述的类似估计值在1927年至1996年之间出生的出生人群的年数已经花在服用任何处方药，具体药物类别和特定数量的处方药。这些估计对围绕处方药使用的当代辩论，包括过度处方，支出，一多药，以及发生不良毒品事件的风险。