A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older

Tessa K Morgan, Margaret Williamson, Marie Pirotta, Kay Stewart, Stephen P Myers and Joanne Barnes
Med J Aust 2012; 196 (1): 50-53.

Objective: To explore the current use of conventional and complementary medicines in Australians aged ? 50 years.

Design, setting and participants: Cross-sectional postal survey sent to a random sample of 4500 Australians aged ? 50 years between June 2009 and February 2010.

Main outcome measures: Prevalence of medicines use, reasons for medicines use and sources of medicines.

Results: Response rate was 37.3%. Medicines use was very common; 87.1% of participants took one or more medicines and 43.3% took five or more in the previous 24 hours. Complementary medicines were used by 46.3% of participants, 87.4% of whom used both conventional and complementary medicines. The most commonly used medicines were antihypertensive agents (43.2% of participants), natural marine and animal products including fish oil and glucosamine (32.4%) and lipid-lowering agents (30.4%). Doctors recommended 79.3% of all medicines and 93.0% of conventional medicines. Pharmacists commonly recommended occasional medicines (ie, as needed), while friends, family and media most often influenced use of complementary medicines.

Conclusions: The use of multiple medicines is common and higher than reported in the 1995 National Health Survey. Today, much medicines use is to prevent future disease by influencing risk factors. High levels of polypharmacy highlight the need to support the safe and effective use of medicines in the community. Although doctors recommend or prescribe most medicines, self-directed medication use is common. This highlights the need for consumer access to accurate information and strategies to improve health literacy about medicines.

The use of medicines for the treatment of disease is a common health-related action by Australians. Medicines are not only used to treat diagnosed medical conditions but, increasingly, to manage risk factors.1 Individuals’ patterns of medicines use are not well understood, including the combined use of prescription, over-the-counter (OTC) and complementary medicines. Smaller surveys of specific populations’ use of medicines have been conducted,2,3 but the most recent Australia-wide survey was the 1995 National Health Survey.4 A majority of published Australian research on the use of medicines is based on the analysis of dispensing data from the Australian Pharmaceutical Benefits Scheme and the Repatriation Pharmaceutical Benefits Scheme; however, these data sources do not include OTC, complementary and unsubsidised prescription medicines.5

Use of and access to medicines is changing. An ageing population is contributing to the national increase in medicine consumption and cost.6 The popularity of complementary medicines has led to increased access to these products through conventional sources of non-prescription medicines, such as pharmacies and supermarkets, as well as through complementary medicine practitioners.7,8 Our study, a national census of medicines use, aimed to address current knowledge gaps by exploring current use of prescription, OTC and complementary medicines, and the patterns and predictors of their use, by Australians aged 50 years and older.
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Reasons for medicines use
More than 150 different reasons for medicines use were reported, including

• 31.1% for cardiovascular conditions,
• 16.6% for musculoskeletal conditions (including joint and bone health) and
• 8.4% for general health and wellbeing (including “energy”, “inner health” and “weight loss”).

The most frequent specific reasons for use were

• hypertension (13.2% of medicines),
• arthritis (8.5%),
• general health (8.0%) and
• lipid lowering (7.2%).

Occasional medicines were most often used for pain relief, including

• headaches (13.0%),
• arthritis (7.6%),
• musculoskeletal pain (including muscle cramps) (7.4%), and
• general pain (6.2%).

Table 3

• Many take 5-9 medicines in a single day

Table 4

• 43% Antihypertensive agents
• 11% vitamin D – not as part of multivitamin
• 30% Lipid-lowering agents

Many of the above problems have been shown to be minimized by having an adequate among of vitamin D

• [|Hypertension]