MEDICATION USEAMONG OLDER

AMERICANS

Research Conducted byInternational Communications Research for theAmerican Society of Health-System Pharmacists

June 2001

ASHP SURVEY ON MEDICATION USEAMONG OLDER AMERICANS REPORT

June 2001

TABLE OF CONTENTS

I. Introduction………………………………………………. 1

II. Key Findings…………………………………………….... 1

General Medication and Supplement Use………………… 1

Doctor’s Visits and Medications………………………….. 2

Drug Interactions and Side Effects……………………….. 2

III. Survey Questions…………………………………………. 5

IV. Survey Methodology……………………………………… 9

1

INTRODUCTION

The American Society of Health-System Pharmacists (ASHP) recently fielded atelephone survey to assess the use of medications among older Americans. The surveywas conducted by International Communications Research (ICR) from April 18-24, 2001,with 275 adults, age 65 and older. Due to the small sample size, only large demographicdifferences will be statistically significant. A detailed description of the methodologycan be found at the end of this report.

The results of this survey will provide a better understanding of the number ofprescription and non-prescription medications that older adults currently use as well astheir knowledge and concerns about drug interactions and side effects. Thisunderstanding will assist ASHP in developing communications materials to educate olderAmericans.

KEY FINDINGS

General Medication and Supplement Use:

• The majority of older Americans take multiple medications, includingprescriptions, non-prescriptions, and supplements. Over three-quarters (76%) ofolder adults take at least three medications, and about one-third (33%) take eight ormore.

Percentage ofolder adults

Number ofmedications

5 18 29 39 48 58 610 733 8 or more

• The majority (82%) of older adults take at least one prescription medication. Overhalf (53%) take three or more prescription medications. Women are more likelythan men to be taking at least three medications (61% vs. 43%).

• About two-thirds (62%) of older Americans take non-prescription medications,including 18% of older adults who take at least three medications.

• Half (52%) of older adults currently take vitamins, minerals or herbalsupplements. One-quarter (26%) take three or more supplements.

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Doctor’s Visits and Medications:

• Three-quarters (78%) of Americans age 65 and older have visited physician practicesor hospitals during the past six months. More than one-quarter (28%) have beento at least three physician practices or hospitals.

• While most older adults have not been prescribed new medications by thesedifferent physicians, the majority are still taking medications that wereprescribed more than six months ago. Only one-third (29%) say they have beenprescribed new medications by health care providers they visited in the past sixmonths. In contrast, seven in ten (72%) are still taking medications prescribed morethan six months ago, including one-third (34%) taking medications prescribed by twoor more physicians.

• Four-in-ten (43%) older Americans have been prescribed prescriptionmedications by more than one physician. A similar percentage (39%) have onlyreceived medications from one physician.

Drug Interactions and Side Effects:

• The majority of older adults say that they discuss medications they are taking withtheir health care providers, including almost half who always talk to their providerabout medications. Older Americans with higher education levels are more likelyto discuss medications with their health care providers (70% of those with somecollege education or more compared to 51% of those with a high school education orless).

• Adults age 65 and older are more likely to find out about drug interactions forprescriptions than for non-prescription medications. Seniors are most likely toobtain information about prescriptions from pharmacists and information about non-prescriptions from other health care providers.

• About half of older adults always look for information on drug interactions for newprescription medications. They are most likely to get this information frompharmacists (47%), physicians (35%), and prescription labels (23%).

• One-third of older Americans look for information on drug interactions for non-prescription medications. They are most likely to get this information fromphysicians (50%), pharmacists (21%), and prescription labels (21%).

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• The vast majority (89%) of older adults feel their health care providers are aware ofall the medications they are taking, including two-thirds who say their physiciansare always aware. Women are more likely than men to feel that their health careproviders are aware of their medications (90% vs. 70%).

Always Usually Sometimes NeverDiscuss Medications with HealthCare Providers

45% 14% 26% 15%

Find Out About Drug Interactionsfor New Prescriptions

53% 9% 8% 24%

Find Out About Drug Interactionsfor Non-Prescription Meds

34% 12% 15% 30%

Physician Aware of Medications 66% 15% 8% 7%

• Those who are more concerned about drug interactions and side effects are morelikely to ask their health care providers for drug information about both newprescription and non-prescription medications.

Seventy percent of those who are concerned about drug interactions ask for druginformation about new prescriptions . Fifty-one percent of those not concernedabout drug interactions request information for new prescriptions .

Sixty-six percent of respondents concerned about negative side effects will ask forinformation about new prescriptions . Fifty-one percent of those not concerned aboutnegative side effects will ask for drug information on new prescriptions .

Fifty-three percent of those who are concerned about drug interactions ask for druginformation about new non-prescription medications . Thirty-nine percent ofrespondents not concerned about drug interactions will ask for drug information fornew non-prescription medications .

Fifty-four percent of those concerned about negative side effects will request druginformation for new non-prescription medications . Thirty-two percent ofrespondents not concerned about negative side effects will request information fornew non-prescription medications .

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• In general, older adults are concerned about side effects and drug interactions.About two-thirds (67%) say they are concerned about negative side effects frommedication, including 44 percent who are very concerned. Similarly, 60 percent ofolder adults are concerned about drug interactions, including 36 percent who are veryconcerned.

Negative SideEffects

Drug Interaction

Very Concerned 44% 36%Concerned 23% 25%Somewhat concerned 10% 12%Not at all concerned 20% 26%

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QUESTIONNAIRE AND RESPONSE FREQUENCIES

RESPONDENT: Age 65-plus

1. How many different prescription medications have you taken in the past week?These are medicines your doctor must give you a prescription for. Do not includeover-the-counter drugs you can purchase in the store without a prescription.

1 16%2 133 or more 53None 15

2. How many different non-prescription medications have you taken in the pastweek, such as aspirin, Tylenol or cough syrup?

1 29%2 153 or more 18None 34

3. How many different vitamins, mineral or herbal supplements, such as St. John’sWort or Gingko Biloba, have you taken in the past week?

1 23%2 33 or more 26None 45

4. Please think about regular doctor visits, emergency room visits and otherhospitalizations, and visits to outpatient clinics. Approximately how manyDIFFERENT physician practices or hospitals did you visit in the past 6 months?

1 30%2 203 or more 28None 20

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5. During the past 6 months, how many of these different physicians or health careproviders have prescribed you NEW medications that you haven’t taken before?

1 19%2 63 or more 4None 68

6. How many different physicians or health care providers prescribed youmedications more than 6 months ago that you STILL CONTINUE to take on anongoing basis?

1 38%2 213 or more 13None 24

7. When you have appointments with your physician or other health care providers,how often do you discuss what medications you are taking with them? (Thisincludes medications you need a prescription for and over-the-counter drugs youcan purchase without a prescription.) Would you say you discuss this all the time,most of the time, sometimes, or never?

All the time 45%Most of the time 14Sometimes 26Never 15

8. When a physician or health care provider prescribes a new medication, how oftendo you ask if it’s okay to take the new prescription along with any othermedications you are already taking?

Always 53%Usually 9Sometimes 8Never 24

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9. How do you usually get information about your medications, such as possible sideeffects or drug interactions, or don’t you usually get this information at all?

Pharmacist 47%Physician/health care provider 35Read label/information given with prescription 23Books 4Family member or friend 3Internet 3Don’t get the information 4

10. When you take a non-prescription medication—such as cough syrup or Tylenol,how often do you try and find out if it’s okay to take the medication along withany other medications you are already taking?

Always 34%Usually 12Sometimes 15Never 30

11. How do you usually get this information?

Physician/health care provider 51%Pharmacist 36Read label/information given with prescription 21Books 5Family member or friend 2Internet 2

12. Overall, how often do you think your physicians or other health care providers areaware of the all the particular medications you are taking? Would you say theyare aware of all the medications you are taking all the time, most of the time,sometimes or never?

All of the time 66%Most of the time 15Sometimes 8Never 7

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13. Overall, how concerned are you about the following?

Negative side effects from a medication

Very concerned 44%Concerned 23Somewhat concerned 10Not concerned at all 20

A drug-interaction problem from taking two or more medications together

Very concerned 36%Concerned 24Somewhat concerned 12Not concerned at all 26

14. Think about all the prescription medication you currently take as well as any youhave taken in the past six months. How many different health care providers orphysicians would you say have prescribed you these different medication?

1 39%2 213 or more 22None 16

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METHODOLOGY

Sample Design: This survey was conducted for the American Society of Health SystemPharmacists by International Communications Research (ICR) by telephone April 18through April 24, 2001, with 275 adults age 65 and over. The sample is based on amethodology designed to produce a representative sample of the U.S. adult population.This representative sample makes use of random-digit selection procedures that assuresample representation of persons in households that are “listed” in telephone directories,as well as persons in households that are “unlisted” in telephone directories. Within eachsample household, one adult respondent is randomly selected using a computerizedprocedure based on the “most recent birthday method” of respondent selection.

Weighting: The data were weighted to the Census Bureau’s latest population parameterson region, education, sex, race, and age. The weighting adjusted these key variables,where necessary, to their actual proportions in the population.

Margin of error: The results achieved from all sample surveys are subject to samplingerror. Sampling error is defined as the difference between the results obtained from thesample and those that would have been obtained had the entire relevant population beensurveyed. The sampling error for the total sample of this survey (n=275) is plus or minus5 percentage points. Please note that when comparing smaller subgroups, such asrespondents divided by gender categories or income, the margin of error increases.