MEDICATION USE AMONG OLDER AMERICANS

Research Conducted by International Communications Research for the American Society of Health-System Pharmacists

June 2001

ASHP SURVEY ON MEDICATION USE AMONG OLDER AMERICANS REPORT

June 2001

TABLE OF CONTENTS

I. II.

Introduction. 1 Key Findings.... 1 General Medication and Supplement Use 1 Doctors Visits and Medications.. 2 Drug Interactions and Side Effects.. 2

III. IV.

Survey Questions. 5 Survey Methodology 9

INTRODUCTION The American Society of Health-System Pharmacists (ASHP) recently fielded a telephone survey to assess the use of medications among older Americans. The survey was 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 demographic differences will be statistically significant. A detailed description of the methodology can be found at the end of this report. The results of this survey will provide a better understanding of the number of prescription and non-prescription medications that older adults currently use as well as their knowledge and concerns about drug interactions and side effects. This understanding will assist ASHP in developing communications materials to educate older Americans.

KEY FINDINGS General Medication and Supplement Use:

The majority of older Americans take multiple medications, including prescriptions, non-prescriptions, and supplements. Over three-quarters (76%) of older adults take at least three medications, and about one-third (33%) take eight or more. Percentage of older adults 5 8 9 9 8 8 10 33 Number of medications 1 2 3 4 5 6 7 8 or more

The majority (82%) of older adults take at least one prescription medication. Over half (53%) take three or more prescription medications. Women are more likely than 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 herbal supplements. One-quarter (26%) take three or more supplements.

Doctors Visits and Medications:

Three-quarters (78%) of Americans age 65 and older have visited physician practices or hospitals during the past six months. More than one-quarter (28%) have been to at least three physician practices or hospitals. While most older adults have not been prescribed new medications by these different physicians, the majority are still taking medications that were prescribed more than six months ago. Only one-third (29%) say they have been prescribed new medications by health care providers they visited in the past six months. In contrast, seven in ten (72%) are still taking medications prescribed more than six months ago, including one-third (34%) taking medications prescribed by two or more physicians. Four-in-ten (43%) older Americans have been prescribed prescription medications by more than one physician. A similar percentage (39%) have only received medications from one physician.

Drug Interactions and Side Effects:

The majority of older adults say that they discuss medications they are taking with their health care providers, including almost half who always talk to their provider about medications. Older Americans with higher education levels are more likely to discuss medications with their health care providers (70% of those with some college education or more compared to 51% of those with a high school education or less). Adults age 65 and older are more likely to find out about drug interactions for prescriptions than for non-prescription medications. Seniors are most likely to obtain information about prescriptions from pharmacists and information about nonprescriptions from other health care providers. About half of older adults always look for information on drug interactions for new prescription medications. They are most likely to get this information from pharmacists (47%), physicians (35%), and prescription labels (23%). One-third of older Americans look for information on drug interactions for nonprescription medications. They are most likely to get this information from physicians (50%), pharmacists (21%), and prescription labels (21%).

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

Discuss Medications with Health Care Providers Find Out About Drug Interactions for New Prescriptions Find Out About Drug Interactions for Non-Prescription Meds Physician Aware of Medications

Always 45% 53% 34% 66%

Usually 14% 9% 12% 15%

Sometimes 26% 8% 15% 8%

Never 15% 24% 30% 7%

Those who are more concerned about drug interactions and side effects are more likely to ask their health care providers for drug information about both new prescription and non-prescription medications. Seventy percent of those who are concerned about drug interactions ask for drug information about new prescriptions . Fifty-one percent of those not concerned about drug interactions request information for new prescriptions . Sixty-six percent of respondents concerned about negative side effects will ask for information about new prescriptions . Fifty-one percent of those not concerned about negative side effects will ask for drug information on new prescriptions . Fifty-three percent of those who are concerned about drug interactions ask for drug information about new non-prescription medications . Thirty-nine percent of respondents not concerned about drug interactions will ask for drug information for new non-prescription medications . Fifty-four percent of those concerned about negative side effects will request drug information for new non-prescription medications . Thirty-two percent of respondents not concerned about negative side effects will request information for new non-prescription medications .

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

Very Concerned Concerned Somewhat concerned Not at all concerned

Negative Side Effects 44% 23% 10% 20%

Drug Interaction 36% 25% 12% 26%

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 include over-the-counter drugs you can purchase in the store without a prescription. 1 2 3 or more None 16% 13 53 15

2.

How many different non-prescription medications have you taken in the past week, such as aspirin, Tylenol or cough syrup? 1 2 3 or more None 29% 15 18 34

3.

How many different vitamins, mineral or herbal supplements, such as St. Johns Wort or Gingko Biloba, have you taken in the past week? 1 2 3 or more None 23% 3 26 45

4.

Please think about regular doctor visits, emergency room visits and other hospitalizations, and visits to outpatient clinics. Approximately how many DIFFERENT physician practices or hospitals did you visit in the past 6 months? 1 2 3 or more None 30% 20 28 20

5.

During the past 6 months, how many of these different physicians or health care providers have prescribed you NEW medications that you havent taken before? 1 2 3 or more None 19% 6 4 68

6.

How many different physicians or health care providers prescribed you medications more than 6 months ago that you STILL CONTINUE to take on an ongoing basis? 1 2 3 or more None 38% 21 13 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? (This includes medications you need a prescription for and over-the-counter drugs you can purchase without a prescription.) Would you say you discuss this all the time, most of the time, sometimes, or never? All the time Most of the time Sometimes Never 45% 14 26 15

8.

When a physician or health care provider prescribes a new medication, how often do you ask if its okay to take the new prescription along with any other medications you are already taking? Always Usually Sometimes Never 53% 9 8 24

9.

How do you usually get information about your medications, such as possible side effects or drug interactions, or dont you usually get this information at all? Pharmacist Physician/health care provider Read label/information given with prescription Books Family member or friend Internet Dont get the information 47% 35 23 4 3 3 4

10.

When you take a non-prescription medicationsuch as cough syrup or Tylenol, how often do you try and find out if its okay to take the medication along with any other medications you are already taking? Always Usually Sometimes Never 34% 12 15 30

11.

How do you usually get this information? Physician/health care provider Pharmacist Read label/information given with prescription Books Family member or friend Internet 51% 36 21 5 2 2

12.

Overall, how often do you think your physicians or other health care providers are aware of the all the particular medications you are taking? Would you say they are aware of all the medications you are taking all the time, most of the time, sometimes or never? All of the time Most of the time Sometimes Never 66% 15 8 7

13.

Overall, how concerned are you about the following? Negative side effects from a medication Very concerned Concerned Somewhat concerned Not concerned at all 44% 23 10 20

A drug-interaction problem from taking two or more medications together Very concerned Concerned Somewhat concerned Not concerned at all 36% 24 12 26

14.

Think about all the prescription medication you currently take as well as any you have taken in the past six months. How many different health care providers or physicians would you say have prescribed you these different medication? 1 2 3 or more None 39% 21 22 16

METHODOLOGY Sample Design: This survey was conducted for the American Society of Health System Pharmacists by International Communications Research (ICR) by telephone April 18 through April 24, 2001, with 275 adults age 65 and over. The sample is based on a methodology designed to produce a representative sample of the U.S. adult population. This representative sample makes use of random-digit selection procedures that assure sample representation of persons in households that are listed in telephone directories, as well as persons in households that are unlisted in telephone directories. Within each sample household, one adult respondent is randomly selected using a computerized procedure based on the most recent birthday method of respondent selection. Weighting: The data were weighted to the Census Bureaus latest population parameters on 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 sampling error. Sampling error is defined as the difference between the results obtained from the sample and those that would have been obtained had the entire relevant population been surveyed. The sampling error for the total sample of this survey (n=275) is plus or minus 5 percentage points. Please note that when comparing smaller subgroups, such as respondents divided by gender categories or income, the margin of error increases.