Use of Prescription and Over-the-counter Medications and Dietary Supplements Among Older Adults in the United States
Open accessAbstract
CONTEXT: Despite concerns about drug safety, current information on older adults' use of prescription and over-the-counter medications and dietary supplements is limited. OBJECTIVE: To estimate the prevalence and patterns of medication use among older adults (including concurrent use), and potential major drug-drug interactions. DESIGN, SETTING, AND PARTICIPANTS: Three thousand five community-residing individuals, aged 57 through 85 years, were drawn from a cross-sectional, nationally representative probability sample of the United States. In-home interviews, including medication logs, were administered between June 2005 and March 2006. Medication use was defined as prescription, over-the-counter, and dietary supplements used "on a regular schedule, like every day or every week." Concurrent use was defined as the regular use of at least 2 medications. MAIN OUTCOME MEASURE: Population estimates of the prevalence of medication use, concurrent use, and potential major drug-drug interactions, stratified by age group and gender. RESULTS: The unweighted survey response rate was 74.8% (weighted response rate, 75.5%). Eighty-one percent (95% confidence interval [CI], 79.4%-83.5%) used at least 1 prescription medication, 42% (95% CI, 39.7%-44.8%) used at least 1 over-the-counter medication, and 49% (95% CI, 46.2%-52.7%) used a dietary supplement. Twenty-nine percent (95% CI, 26.6%-30.6%) used at least 5 prescription medications concurrently; this was highest among men (37.1%; 95% CI, 31.7%-42.4%) and women (36.0%; 95% CI, 30.2%-41.9%) aged 75 to 85 years. Among prescription medication users, concurrent use of over-the-counter medications was 46% (95% CI, 43.4%-49.1%) and concurrent use of dietary supplements was 52% (95% CI, 48.8%-55.5%). Overall, 4% of individuals were potentially at risk of having a major drug-drug interaction; half of these involved the use of nonprescription medications. These regimens were most prevalent among men in the oldest age group (10%; 95% CI, 6.4%-13.7%) and nearly half involved anticoagulants. No contraindicated concurrent drug use was identified. CONCLUSIONS: In this sample of community-dwelling older adults, prescription and nonprescription medications were commonly used together, with nearly 1 in 25 individuals potentially at risk for a major drug-drug interaction.
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Older adults are most vulnerable to poor medication adherence.
“Research evidence reveals that older adults are most vulnerable to poor medication adherence, and this is particularly due to advanced age,5–8 forgetfulness, diminished visual acuity, poor coordination, decreased physical strength and changing medication schedules,2 9 10 which are linked with multiple factors that are negatively associated with adherence.”
From Effectiveness of eHealth interventions targeted to improve medication adherence among older adults with mild cognitive impairment: a protocol for a systematic review and meta-analysis (2022) · cites this paper as [8]
The Comment section says older adults are most vulnerable to adverse medication effects and drug interactions, not poor adherence. The introduction mentions nonadherence only as a reason pharmacy claims can overestimate medication use. Searches for adherence, nonadherence, and age-related risk found no comparison showing that older adults are most vulnerable to poor adherence; page numbers were not available in our copy. (LLM, conf=0.76)
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- Authors
- Qato, D. M., Alexander, G. C., Conti, R. M., Johnson, M., Schumm, L. P., & Lindau, S. T.
- Affiliations
- University of Chicago (US)
- University of Illinois Chicago (US)
- Corresponding author
- Dima Mazen Qato
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-12-24
- Volume
- 300
- Issue
- 24
- Pages
- 2867
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC2702513
- OpenAlex
- W1736805871
- Semantic Scholar
- 68d9817d38ee67d7a584c4b941e4b4e70842f0b8
- Cited by
- 995
- References
- 23
- Citations by year
- 2026: 13 · 2025: 37 · 2024: 30 · 2023: 42 · 2022: 44 · 2021: 54 · 2020: 45 · 2019: 62 · 2018: 66 · 2017: 75 · 2016: 82 · 2015: 83 · 2014: 65 · 2013: 69 · 2012: 78
- FWCI
- 20.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (K08 HS15699-01A1, K08HS015699)
- National Institute on Aging (P30AG012857, R21AG049283, R01AG021487, K23AG032870)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- medication use, older adults, prescription drugs, over-the-counter drugs, dietary supplements, polypharmacy, concomitant medications, drug-drug interactions, gender differences, age differences, community-dwelling older adults, drug safety
- MeSH terms
- Aged, Aged, 80 and over, Drug Interactions, Drug Utilization, Nonprescription Drugs, Female, Health Status, Health Surveys, Humans, Male, Middle Aged, Risk, Socioeconomic Factors, United States, Comorbidity, Dietary Supplements, Prescription Drugs
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