OBJECTIVE: To determine the pharmacoepidemiology of
prescription drug use in a rural elderly community sample,
specifically the numbers and categories of medications taken and the
factors associated with them.
DESIGN: Cross-sectional
community survey.
SETTING: The mid-Monongahela Valley of
southwestern Pennsylvania.
PARTICIPANTS: An age-stratified
random sample of 1360 community-dwelling individuals, aged 65 years
and older.
MEASURES: Self-reported use of prescription drugs
demographic characteristics, and use of health services.
RESULTS:
Nine hundred sixty-seven participants (71%) reported regularly
taking at least one prescription medication and 157 (10%) reported
taking five or more medications (median 2.0, range 0-13). Women took
significantly more medications than men (median 2.0, range 0-13 and
median 1.0, range 0-9, respectively; p = 0.01). The use of a greater
number of medications was independently and statistically
significantly associated with older age, hospitalization within the
previous 6 months, home health care in previous year, visit to a
physician within the previous year, and insurance coverage for
prescription medication. Individuals older than 85 years were
significantly more likely to be taking cardiovascular agents,
anticoagulants, vasodilating agents, diuretics, and potassium
supplements. Significantly more women than men were taking
nonsteroidal antiinflammatory drugs, antidepressants, potassium
supplements, and thyroid replacement medications.
CONCLUSIONS:
Both the number and the types of prescription medications vary with
age and gender. The demographic and health service use variables
associated with greater medication use in the community may help
define high-risk groups for polypharmacy and adverse drug reactions.
Longitudinal studies are needed.