Prescription medication use and trends for U.S. Navy submariners from 2007 to 2018

Abstract

Introduction: This is the first study to examine population medication prescription rates among U.S. submariners by common therapeutic classifications. Methods: Individual-level pharmacy records during the years 2007 to 2018 were extracted from the Military Health System’s Pharmacy Data Transaction Service (PDTS) file. Demographic and military factors captured from Navy personnel files were linked to PDTS records. Logistic regression models were used to identify characteristics and trends associated with prevalence. Published total rates for other active-duty components were compared to submariner rates. Results: There were data for 50,720 submariners, among whom 576,782 prescriptions were filled. Prevalence rates decreased significantly from 2007-2018 among most drug classes. Central nervous system agents accounted for 31% of the total prescriptions, followed by 12% for eye, ear, nose, and throat preparations, and 10% for anti-infective agents. Higher prescription rates were associated with being enlisted, younger, a woman, lower-ranked, or Hispanic. The mean yearly prescription rate was 2.7 per submariner, less than half of the overall rate of all military components. Conclusions: Central nervous system agents were the most common drug class for submariners and all military components. Future work at the drug level is warranted to better understand the temporal declines in submariner rates and if submariner rates are lower than overall active-duty rates due to health status measures, sex, or allowance guidelines. Drug-level utilization can help determine if onboard medications should be adjusted to meet the current needs of men, and the needs of the growing submariner population of women.