Evaluating the impact of adverse childhood experiences on medication use

Abstract

Introduction Socioeconomic adversities in early life predicts adulthood diseases. However, literature evaluating childhood adversity and number of medications prescribed is limited. Objectives Our aim is to assess the number of disease states, chronic medications prescribed, and discrepancies that may be encountered on a patient and system level. Methods This single-center, prospective cohort study included adults ≥18 years old who provided informed consent. Participants were asked to bring all medications to their visit where a medication history was conducted. Medication discrepancies from the interview and patient chart were stratified by patient or system error. Participants were asked to answer a questionnaire regarding their beliefs about medications and their adherence patterns. Results Thirty-eight patients were enrolled over 27 months. The median number of disease states and chronic medications per patient was 6 (4–9) and 9.5 (5–14), respectively. The median adverse childhood event (ACE) score was 5 (3–7). Patients with ACE scores <5 had a median of 4.5 (3–7) disease states compared with a median of 6.5 (4–10) for patients with scores ≥5 (P = 0.0638). Patients with ACE scores <5 were taking a median of 3.5 (3-8.5) chronic medications compared with 12.5 (6–16) for patients with scores ≥5 (P = 0.0025). There were a total of 105 patient discrepancies and 167 system discrepancies in relation to chronic medication use. Patients with ACE scores <5 had a median of 1.5 (1-2.5) patient discrepancies and 3 (1–5) system discrepancies. Patients with ACE scores ≥5 had a median of 3 (1–4) patient discrepancies and 4 (1–6) system discrepancies. Conclusion Patients with higher ACE scores had more comorbid disease states and chronic medications. Patient and system medication discrepancies were abundant among all patients, regardless of ACE score.