Age and Sex Patterns of Drug Prescribing in a Defined American Population
Division of Epidemiology, Mayo Clinic, Rochester, MN. Mayo Clinic Proceedings
(Impact Factor: 6.26).
06/2013; 88(7). DOI: 10.1016/j.mayocp.2013.04.021
To describe the age and sex patterns of drug prescribing in Olmsted County, Minnesota.
Population-based drug prescription records for the Olmsted County population in 2009 were obtained using the Rochester Epidemiology Project medical records linkage system (n=142,377). Drug prescriptions were classified using RxNorm codes and were grouped using the National Drug File-Reference Terminology.
Overall, 68.1% of the population (n=96,953) received a prescription from at least 1 drug group, 51.6% (n=73,501) received prescriptions from 2 or more groups, and 21.2% (n=30,218) received prescriptions from 5 or more groups. The most commonly prescribed drug groups in the entire population were penicillins and β-lactam antimicrobials (17%; n=23,734), antidepressants (13%; n=18,028), opioid analgesics (12%; n=16,954), antilipemic agents (11%; n=16,082), and vaccines/toxoids (11%; n=15,918). However, prescribing patterns differed by age and sex. Vaccines/toxoids, penicillins and β-lactam antimicrobials, and antiasthmatic drugs were most commonly prescribed in persons younger than 19 years. Antidepressants and opioid analgesics were most commonly prescribed in young and middle-aged adults. Cardiovascular drugs were most commonly prescribed in older adults. Women received more prescriptions than men for several drug groups, in particular for antidepressants. For several drug groups, use increased with advancing age.
This study provides valuable baseline information for future studies of drug utilization and drug-related outcomes in this population.
Available from: Sarah Slight
- "Nearly 70% of Americans are prescribed at least one prescription drug, and 20% use five or more . "
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Patient-centered approaches to improving medication adherence hold promise, but evidence of their effectiveness is unclear. This review reports the current state of scientific research around interventions to improve medication management through four patient-centered domains: shared decision-making, methods to enhance effective prescribing, systems for eliciting and acting on patient feedback about medication use and treatment goals, and medication-taking behavior.
We reviewed literature on interventions that fell into these domains and were published between January 2007 and May 2013. Two reviewers abstracted information and categorized studies by intervention type.
We identified 60 studies, of which 40% focused on patient education. Other intervention types included augmented pharmacy services, decision aids, shared decision-making, and clinical review of patient adherence. Medication adherence was an outcome in most (70%) of the studies, although 50% also examined patient-centered outcomes.
We identified a large number of medication management interventions that incorporated patient-centered care and improved patient outcomes. We were unable to determine whether these interventions are more effective than traditional medication adherence interventions.
Additional research is needed to identify effective and feasible approaches to incorporate patient-centeredness into the medication management processes of the current health care system, if appropriate.
Patient Education and Counseling 09/2014; 97(3). DOI:10.1016/j.pec.2014.08.021 · 2.20 Impact Factor
Available from: Alistair Victor Nunn
- "However, for most developed countries in 2010, the healthy life expectancy was still closer to 70 years, with an absolute expectancy of 80 years or so . In fact, there is even evidence that in some countries, such as the USA, it may actually start to fall due to obesity ; this is further supported by evidence that nearly 70% of the population in the USA are receiving some kind of medication . Hence, it appears that the maximal lifespan of humans is fixed, as it is for most other animals, and although many people are living longer, as a species, we are not getting much closer to the theoretical limit due to our increasingly comfortable environment. "
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ABSTRACT: Mankind is facing an unprecedented health challenge in the current pandemic of obesity and diabetes. We
propose that this is the inevitable (and predictable) consequence of the evolution of intelligence, which itself
could be an expression of life being an information system driven by entropy. Because of its ability to make life
more adaptable and robust, intelligence evolved as an efficient adaptive response to the stresses arising from an
ever-changing environment. These adaptive responses are encapsulated by the epiphenomena of “hormesis”, a
phenomenon we believe to be central to the evolution of intelligence and essential for the maintenance of optimal
physiological function and health. Thus, as intelligence evolved, it would eventually reach a cognitive level with the
ability to control its environment through technology and have the ability remove all stressors. In effect, it would
act to remove the very hormetic factors that had driven its evolution. Mankind may have reached this point,
creating an environmental utopia that has reduced the very stimuli necessary for optimal health and the evolution
of intelligence – “the intelligence paradox”. One of the hallmarks of this paradox is of course the rising incidence in
obesity, diabetes and the metabolic syndrome. This leads to the conclusion that wherever life evolves, here on earth
or in another part of the galaxy, the “intelligence paradox” would be the inevitable side-effect of the evolution of
intelligence. ET may not need to just “phone home” but may also need to “phone the local gym”. This suggests
another possible reason to explain Fermi’s paradox; Enrico Fermi, the famous physicist, suggested in the 1950s that
if extra-terrestrial intelligence was so prevalent, which was a common belief at the time, then where was it? Our
suggestion is that if advanced life has got going elsewhere in our galaxy, it can’t afford to explore the galaxy
because it has to pay its healthcare costs.
Nutrition and metabolism 07/2014; 11(1):34. DOI:10.1186/1743-7075-11-34
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ABSTRACT: To report the design and implementation of the first 3 years of enrollment of the Mayo Clinic Biobank.
Preparations for this biobank began with a 4-day Deliberative Community Engagement with local residents to obtain community input into the design and governance of the biobank. Recruitment, which began in April 2009, is ongoing, with a target goal of 50,000. Any Mayo Clinic patient who is 18 years or older, able to consent, and a US resident is eligible to participate. Each participant completes a health history questionnaire, provides a blood sample, and allows access to existing tissue specimens and all data from their Mayo Clinic electronic medical record. A community advisory board provides ongoing advice and guidance on complex decisions.
After 3 years of recruitment, 21,736 individuals have enrolled. Fifty-eight percent (12,498) of participants are female and 95% (20,541) of European ancestry. Median participant age is 62 years. Seventy-four percent (16,171) live in Minnesota, with 42% (9157) from Olmsted County, where the Mayo Clinic in Rochester, Minnesota, is located. The 5 most commonly self-reported conditions are hyperlipidemia (8979, 41%), hypertension (8174, 38%), osteoarthritis (6448, 30%), any cancer (6224, 29%), and gastroesophageal reflux disease (5669, 26%). Among patients with self-reported cancer, the 5 most common types are nonmelanoma skin cancer (2950, 14%), prostate cancer (1107, 12% in men), breast cancer (941, 4%), melanoma (692, 3%), and cervical cancer (240, 2% in women). Fifty-six percent (12,115) of participants have at least 15 years of electronic medical record history. To date, more than 60 projects and more than 69,000 samples have been approved for use.
The Mayo Clinic Biobank has quickly been established as a valuable resource for researchers.
Mayo Clinic Proceedings 09/2013; 88(9):952-62. DOI:10.1016/j.mayocp.2013.06.006 · 6.26 Impact Factor
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