Skip to main content
SpringerLink
Log in

Epidemiology of Over-the-Counter Drug Use in Community Dwelling Elderly

United States Perspective

  • Review Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Among US community dwelling individuals aged ≥65 years, about as many persons take nonprescription drugs as take prescription drugs. A review of US data from the last 2 decades indicates that the average number of over-the-counter (OTC) drugs taken daily is around 1.8, but varies with geographical area (highest in the Midwest) and race/ethnicity (lowest use among Hispanics, followed by African Americans, and highest use among Whites). Use has consistently been found to be higher in women than in men. While OTC use appears to be increasing over time, it also decreases with increase in age. The most common OTC classes used are analgesics, laxatives and nutritional supplements. Our ability to explain or to predict OTC use and change in use is poor, and further studies, particularly on use by elderly individuals of minority races, are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III
Table IV

Similar content being viewed by others

References

  1. Covington TR, editor. Handbook of nonprescription drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996

    Google Scholar 

  2. Rheinstein PH. Prescription to over the counter drug switches: FDA perspective. Am Fam Physician 1997; 56: 1211–4

    PubMed  CAS  Google Scholar 

  3. Stewart RB. Drug use in the elderly. In: Delafuente JC, Stewart RB, editors. Therapeutics in the elderly. 3rd ed. Cincinnati (OH): Harvey Whitney Books, 2000: 235–56

    Google Scholar 

  4. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 1998; 280: 1569–75

    Article  PubMed  CAS  Google Scholar 

  5. Caranasos GJ, Stewart RB, Cluff LE. Drug induced illness leading to hospitalization. JAMA 1974; 228: 713–7

    Article  PubMed  CAS  Google Scholar 

  6. Comptroller General Nonprescription drugs. Over the counter and underemphasized. Washington (DC): United States General Accounting Office, 1992 Jan: GAO/PEMD-92-99

  7. Young FE. Self-care, self-medication in America’s future. FDA Consumer 1989; 22(10): 6–7

    Google Scholar 

  8. Coons JS, Johnson M, Chandler MHH. Sources of self-treatment information and use of home remedies and over-the-counter medications among older adults. J Geriatr Drug Ther 1992; 7: 71–82

    Google Scholar 

  9. New labels for over-the-counter medicines: author receives plain language award [online]. Available from URL: http://www.fda.gov/cder/otc/label/ (Accessed 2001 Jan 31

  10. Espino DV, Lichtenstein MJ, Hazuda HP, et al. Correlates of prescription and over-the-counter medication usage among older Mexican Americans: the Hispanic EPESE study. Established Population for the Epidemiologic Study of the Elderly. J Am Geriatr Soc 1998; 46: 1228–34

    PubMed  CAS  Google Scholar 

  11. Helling DK, Lemke JH, Semla TP, et al. Medication use characteristics in the elderly: the Iowa 65+ Rural Health Study. J Am Geriatr Soc 1987; 35: 4–12

    PubMed  CAS  Google Scholar 

  12. Hanlon JT, Fillenbaum GG, Burchett B, et al. Drug use patterns in black and nonblack community dwelling elderly. Ann Pharmacother 1992; 26: 679–85

    PubMed  CAS  Google Scholar 

  13. Stoehr GP, Ganguli M, Seaberg EC, et al. Over-the-counter medication use in an older rural community: the MoVIES Project. J Am Geriatr Soc 1997; 45: 158–65

    PubMed  CAS  Google Scholar 

  14. Cadigan DA, Magaziner J, Fedder DO. Polymedicine use among community resident older women: how much a problem? Am J Public Health 1989; 79: 1537–40

    Article  PubMed  CAS  Google Scholar 

  15. Darnell JC, Murray MD, Martz BL, et al. Medication use by ambulatory elderly. J Am Geriatr Soc 1986; 34: 1–4

    PubMed  CAS  Google Scholar 

  16. Chrischilles EA, Foley DJ, Wallace RB, et al. Use of medications by persons 65 and over: data from the Established Populations for Epidemiologic Studies of the Elderly. J Gerontol 1992; 47: M137–44

    Article  PubMed  CAS  Google Scholar 

  17. Cartwright A, Smith C, editors. Elderly people, their medicines, and their doctors. London: Routledge, 1988

    Google Scholar 

  18. Stewart RB, Moore MT, May FE, et al. A longitudinal evaluation of drug use in an ambulatory elderly population. J Clin Epidemiol 1991; 44: 1353–4

    Article  PubMed  CAS  Google Scholar 

  19. Stoller EP. Prescribed and over-the-counter medicine use by the ambulatory elderly. Med Care 1988; 26: 1149–57

    Article  PubMed  CAS  Google Scholar 

  20. Cohen I, Rogers P, Burke V, et al. Predictors of medication use, compliance and symptoms of hypotension in a community-based sample of elderly men and women. J Clin Pharm Ther 1998; 23: 423–32

    Article  PubMed  CAS  Google Scholar 

  21. Fillenbaum GG, Hanlon JT, Corder EH, et al. Prescription and nonprescription drug use among black and white community-residing elderly. Am J Public Health 1993; 83: 1577–82

    Article  PubMed  CAS  Google Scholar 

  22. Stewart RB, Moore MT, May FE, et al. Changing patterns of therapeutic agents in the elderly: a ten-year overview. Age Ageing 1991; 20: 182–8

    Article  PubMed  CAS  Google Scholar 

  23. Fillenbaum GG, Horner R, Hanlon J, et al. Factors predicting change in prescription and non-prescription drug use in a community-residing black and white elderly population. J Clin Epidemiol 1996; 49: 587–93

    Article  PubMed  CAS  Google Scholar 

  24. Andersen R, Aday L. A framework for the study of access to medical care. Health Serv Res 1974; 9: 208–20

    PubMed  Google Scholar 

  25. Sharpe TR, Smith MC, Barbie ER. Medicine use among the rural elderly. J Health Soc Behav 1985; 26: 113–27

    Article  PubMed  CAS  Google Scholar 

  26. Eve SB, Friedsam HJ. Use of tranquilizers and sleeping pills among older Texans. J Psychoactive Drugs 1981; 13: 165–73

    Article  PubMed  CAS  Google Scholar 

  27. Hale WE, May FE, Marks RG, et al. Drug use in an ambulatory elderly population: a five year update. Drug Intell Clin Pharm 1987; 21: 530–535

    PubMed  CAS  Google Scholar 

  28. Anon. Ibuprofen without a prescription. Med Lett Drugs Ther; 26: 63–5

  29. Stewart RB, Hale WE, Marks RG. Analgesic use in an ambulatory elderly population. Drug Intell Clin Pharm 1982; 16: 833–6

    PubMed  CAS  Google Scholar 

  30. Chrischilles EA, Lemke JH, Wallace RB, et al. Prevalence and characteristics of multiple analgesic use in an elderly study group. J Am Geriatr Soc 1990; 38: 979–84

    PubMed  CAS  Google Scholar 

  31. Hanlon JT, Fillenbaum GG, Studenski SA, et al. Suboptimal analgesic use in community dwelling elderly. Ann Pharmacother 1996; 30: 739–44

    PubMed  CAS  Google Scholar 

  32. Stewart RB, May FE, Hale WE, et al. Laxative use among an ambulatory elderly population: a report from the Dunedin program. Contemp Pharm Pract 1982; 5: 166–9

    Google Scholar 

  33. Ruby CM, Fillenbaum GG, Kuchibhatla MN, et al. Laxative use in community dwelling elderly [abstract]. Gerontologist 1999; 39(Special Issue 1): 473

    Google Scholar 

  34. Gray SL, Hanlon JT, Fillenbaum GG, et al. Predictors of nutritional supplement use in the elderly. Pharmacotherapy 1996; 16: 715–20

    PubMed  CAS  Google Scholar 

  35. Ervin RB, Wright JD, Kennedy-Stephenson J. Use of dietary supplements in the United States, 1988–94. Vital Health Stat 11 1999; 244

    Google Scholar 

  36. Stewart RB. Nutritional supplements in the ambulatory elderly population: patterns of use and requirements. DICP 1989; 23: 490–5

    PubMed  CAS  Google Scholar 

  37. Block G, Cox C, Madans J, et al. Vitamin supplement use, by demographic characteristics. Am J Epidemiol 1988; 127: 297–309

    PubMed  CAS  Google Scholar 

  38. Houston DK, Johnson MA, Daniel TD, et al. Health and dietary characteristics of supplement users in an elderly population. Int J Vitam Nutr Res 1997; 67(3): 183–91

    PubMed  CAS  Google Scholar 

  39. Batty GM, Oborne CA, Swift CG, et al. The use of over-the-counter medication by elderly medical in-patients. Postgrad Med J 1997; 73: 720–2

    Article  PubMed  CAS  Google Scholar 

  40. Torrible SJ, Hogan DB. Medication use and rural seniors: who really knows what they are taking? Can Fam Physician 1997; 43: 893–8

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Brenda Davis and Kay Fox for their help in preparing the manuscript. Financial support was provided by grants from the National Institute on Aging (R01-AG-15432 — Drs Hanlon, Fillenbaum and Ruby and R01-AG-14158 — Drs Hanlon and Ruby, R37-AG-08937 — Dr Fillenbaum, and K08-AG-00808 — Dr Gray) and the VFW Endowed Chair in Geriatric Pharmacotherapy, College of Pharmacy, University of Minnesota (Dr Hanlon).

Author information

Authors and Affiliations

  1. College of Pharmacy, Institute for the Study of Geriatric Pharmacotherapy and Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota, USA

    Joseph T. Hanlon

  2. School of Public Health, Division of Health Services Research and Policy, University of Minnesota, Minneapolis, Minnesota, USA

    Joseph T. Hanlon

  3. Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA

    Joseph T. Hanlon

  4. Center for the Study of Aging and Human Development, Durham, North Carolina, USA

    Gerda G. Fillenbaum & Christine M. Ruby

  5. Departments of Psychiatry and Behavioural Sciences, and Medicine, Division of Geriatrics, Duke University Medical Center, Durham, North Carolina, USA

    Gerda G. Fillenbaum & Christine M. Ruby

  6. Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Durham, North Carolina, USA

    Christine M. Ruby

  7. School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA

    Christine M. Ruby

  8. School of Pharmacy, University of Washington, Seattle, Washington, USA

    Shelly Gray

  9. Pharmaceutical Branch, Proctor and Gamble, Mason, Ohio, USA

    Arline Bohannon

Authors
  1. Joseph T. Hanlon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gerda G. Fillenbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christine M. Ruby
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shelly Gray
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arline Bohannon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph T. Hanlon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hanlon, J.T., Fillenbaum, G.G., Ruby, C.M. et al. Epidemiology of Over-the-Counter Drug Use in Community Dwelling Elderly. Drugs & Aging 18, 123–131 (2001). https://doi.org/10.2165/00002512-200118020-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-200118020-00005

Keywords

Search

Navigation