Prescription Drug Use Research Articles

Non-medical use of tranquilizers and sedatives by 15-16-year-old adolescents in Estonia, 2003–2019

Abstract Background Non-medical use of prescription drugs has become a global concern in recent decades. This study aimed to explore trends in non-medical tranquilizers and sedatives use (NTSU) among adolescents in Estonia from 2003 to 2019. Methods Utilizing data from the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 2003-2019, study included 15-16-year-old Estonian schoolchildren (n = 11,328; 48.6% boys). Cochran-Armitage test was employed to assess changes in NTSU trends, with statistical significance set at p < 0.05. Prevalence rates and 95% CIs used as outcome measures. Results From 2003 to 2019, the lifetime prevalence of NTSU significantly increased for both genders, with girls consistently showing higher rates. Among boys, NTSU rose from 5.0% (95% CI 3.8-6.5) to 11.3% (95% CI 9.6-13.3), particularly among those reporting NTSU 1-2 times, from 3.0% (95% CI 2.1-4.2) to 8.2% (95% CI 6.7-9.9), p < 0.001. Similarly, for girls, NTSU rose from 12.6% (95% CI 10.7-14.7) to 17.5% (95% CI 15.4-19.7), p < 0.001. There was an increase among girls reporting NTSU 1-2 times from 7.5% (95% CI 6.0-9.2) to 10.6% (95% CI 9.0-12.4), p < 0.001, and those reporting NTSU three or more times, from 5.1% (95% CI 3.9-6.6) to 6.9% (95% CI 5.6-8.4), p = 0.017. Among boys reporting medical tranquilizers and sedatives use (MTSU), NTSU rose from 21.1% (95% CI 13.9 to 30.0) in 2003 to 41.4% (95% CI 32.3 to 50.9) in 2019, p = 0.006. However, there was no statistically significant change in NTSU among girls reporting MTSU, remaining at 44.1% (95% CI 36.0 to 52.4) in 2019, p = 0.951. Conclusions Study reveals a significant increase in lifetime NTSU from 2003 to 2019, with girls consistently showing higher prevalence. Targeted interventions are needed to address adolescent non-medical prescription drug use, particularly among girls. Moreover, substantial NTSU among those reporting MTSU highlights the need to monitor and address non-medical usage in this subgroup. Key messages • Estonian adolescent non-medical tranquilizers and sedatives use surged from 2003 to 2019, particularly among girls, highlighting the need for targeted interventions. • The high prevalence of non-medical tranquilizer and sedative use among those reporting medical tranquilizer and sedative use underscores the necessity for vigilant monitoring.

Prescribed Drug Use and Aneurysmal Subarachnoid Hemorrhage Incidence: A Drug-Wide Association Study.

Prescribed Drug Use and Aneurysmal Subarachnoid Hemorrhage Incidence: A Drug-Wide Association Study.

Interventional Pharmacoepidemiology: Origins, Current Status, and Future Possibilities.

Interventional pharmacoepidemiology applies quantitative analysis of patterns of medication use and outcomes to help design, guide and then evaluate programs to improve prescription drug use and outcomes. Surveillance of prescribing and drug-taking in large populations is increasingly practical because of the proliferation of detailed data on medication use decisions, often based on paid claims billing data. At the same time, increasingly granular clinical information is available on patient characteristics and outcomes. This can offer important opportunities to identify problematic use, focus interventions to address them, and measure their impact. Alexander et al (Am J Epidemiol. 0000;000(00):0000-0000) review the need for such research and provide methodological guidance for its performance. While randomized controlled trials of such interventions are ideal, real-world considerations often require other evaluation strategies, including stepped-wedge designs and interrupted time-series analysis. As drug therapy becomes more powerful and more costly, and the risks of poor medication choices as well as under-use of effective treatments become even better understood, the health care system will increasingly rely on such approaches to assess current patterns of prescribing and patient adherence, target programs to address problem areas, and measure the effectiveness of such interventions.

Do Symptoms of Depression Moderate the Links Between Reactive and Proactive Aggression and Frequency of Substance Use?

Youth substance use continues to be a public health concern, with both aggressive behavior and symptoms of depression commonly identified as risk factors for adolescent substance use. However, more research is needed to understand how proactive and reactive functions of aggression are uniquely associated with the frequency of use of specific substances and how these functions of aggression interact with symptoms of depression to contribute to substance use. To this end, the current study examined these associations in a sample of detained youth (N = 229; 80.7% Male). Results suggested that reactive aggression is uniquely associated with traditional cigarette, alcohol, and marijuana use, while proactive aggression is uniquely associated with prescription drug use. Further, although symptoms of depression did not uniquely contribute to the frequency of substance use, symptoms of depression moderate links between proactive aggression and frequency of traditional cigarette, alcohol, and prescription drug use such that proactive aggression is associated with increased frequency of use only when symptoms of depression are low. Findings suggest the need to consider functions of aggression when identifying risk for frequent substance use, as there may be distinct targets of intervention depending on the function of aggression.

Self-Medication of Medical Students at Erzincan Binali Yıldırım University in Turkey: A Cross-Sectional Study.

Responsible self-medication (SM) can save time, money, reduce the number of visits to the doctor, and alleviate pressure on health services. However, while there are clear benefits, SM also carries significant risks, such as increased drug side effects, inappropriate use of prescription drugs, drug interactions, misdiagnosis, drug dependence, masking of medical conditions, and antibiotic resistance. This study aimed to investigate the practices of medical students at a public university in Türkiye towards SM, as well as to determine the factors influencing such practices. The population of this cross-sectional study included first-, fourth-, and sixth-year medical students. As the goal was to reach the entire population (375 students), no sample selection was made. A total of 332 students (88.5%) participated in the study.The relevant literature was used for the basis of the questionnaire used in the study. In the statistical evaluation, percentages, means, standard deviations, medians, minimum, and maximum values were used to present the descriptive data, while factors influencing SM were analyzed using the chi-square test and bivariate and multivariate logistic regression analysis. The overall rate of SM among the participants was found to be 96.1%. No statistically significant difference was observed in SM rates based on the year of study (p>0.05). The rate of students using antibiotics without a prescription was 19.3%. Additionally, 82.5% of the students reported reading the package insert before using a drug. The most common symptoms leading to SM were headaches (83.1%) and the common cold (63.6%). The most frequently self-administered medications were analgesics (86.1%), common cold medicines (54.8%), and vitamins (34.0%). Furthermore, 79.3% of the participants indicated that they self-medicate because they perceive their condition as a simple illness, 64.6% because they had experienced a similar illness before, and 28.2% because they believed they had sufficient knowledge of medications.In multivariate regression analysis, keeping medicines at home/in the dormitory for later use and not having a chronic disease were found to be effective factors in students' practice of SM. It is important to plan educational interventions to promote the development of responsible SM behaviors. Starting these educational programs in the first year of medical school is thought to contribute significantly to the fostering of responsible SM practices.

Prevalence and Patterns of Drug Use Among People in Al-Najaf Governorate, Iraq

Background: After a series of instability Iraq confronted in the past decades, the drug abuse issue has grown and is now a complex national concern where the rise in drug transshipment through the country and neighbor countries accompanies noticeable increased consumption of drugs especially those associated with transnational criminal networks such as amphetamines. This is a descriptive cross-sectional epidemiological study conducted in Al-Najaf governorate from January to March 2024, qualitative data based on the correction institutions of the Ministry of the Interior using a non-probability sample since lack of precise sample frame or data about the real prevalence or rate of the problem. The study recruited 288 drug users all between 20-64 years, 31(10.8%) were females and 257(89.2%) were males (49%). 237 (82%) of the drug users of young adults between 20 to 40 years old. The objective was to investigate personal history and examine the extent and patterns of the abuse of drugs, using a structured questionnaire designed and modified after reviewing relevant studies. The study found that the majority of the participants smoked nicotine throughout their lifetime as 60.8% smoked hookah, 15% smoked e-cigarettes and 86% smoked cigarettes with about 75% current heavy smokers, 51% of participants used alcohol as lifetime prevalence with more than 32% used it weekly. A large percentage: 88% abused more than one type of illicit drug with amphetamine stimulants (methamphetamine and fenethylline) as the most commonly abused illicit drugs among the majority of the participants. The lifetime prevalence of prescription drug use was 86%. 60% used more than one method of administration, while 8% used drugs by injection. The study concluded that a large percentage of the study participants were polydrug abusers with extensive patterns of use which revealed the complex status of which stresses a holistic approach to managing the problem. Conclusion: The study concluded that a large percentage of the study participants were polydrug abusers with extensive patterns of use which revealed the complex status of which stresses a holistic approach to manage the problem.

High-performance liquid chromatography coupled to Orbitrap mass spectrometry for screening of common new psychoactive substances and other drugs in biological samples.

The complexity of the drug market and the constant updating of drugs have been challenging issues for drug regulatory authorities. With the emergence of new psychoactive substances (NPS) and the nonmedical use of prescription drugs, forensic and toxicology laboratories have had to adopt new drug screening methods and advanced instrumentation. Using high-performance liquid chromatography coupled with Orbitrap mass spectrometry, we developed a screening method for common NPS and other drugs. Two milliliters of mixed solvent of n-hexane and ethyl acetate (1:1, v:v) were added to 500 μL of blood or urine sample for liquid-liquid extraction, and methanol extraction was used for hair samples. The developed method was applied to 3897 samples (including 332 blood samples, 885 urine samples, and 2680 hair samples) taken from drug addicts in a province of China during 2019-2021. For urine and blood samples, the limits of detection (LODs) ranged from 1.68 pg/mL to 10.7 ng/mL. For hair samples, the LODs ranged from 3.30 × 10-5 to 4.21 × 10-3 ng/mg. The matrix effects of urine, blood, and hair samples were in the range of 47.6%-121%, 39.8%-139%, and 6.35%-118%, respectively. And the intra-day precision was 3.5%-6.0% and the inter-day precision was 4.18%-9.90%. Analysis of the actual samples showed an overall positive detection rate of 58.9%, with 5.32% of the samples indicating the use of multiple drugs.

Changes in adolescents' nonmedical use of prescription drugs

Changes in adolescents' nonmedical use of prescription drugs

Prescribed Drug Use and Aneurysmal Subarachnoid Hemorrhage Incidence: A Drug-Wide Association Study.

Current benefits of invasive intracranial aneurysm treatment to prevent aneurysmal subarachnoid hemorrhage (aSAH) rarely outweigh treatment risks. Most intracranial aneurysms thus remain untreated. Commonly prescribed drugs reducing aSAH incidence may provide leads for drug repurposing. We performed a drug-wide association study (DWAS) to systematically investigate the association between commonly prescribed drugs and aSAH incidence. We defined all aSAH cases between 2000 and 2020 using International Classification of Diseases codes from the Secure Anonymised Information Linkage databank. Each case was matched with 9 controls based on age, sex, and year of database entry. We investigated commonly prescribed drugs (>2% in study population) and defined 3 exposure windows relative to the most recent prescription before index date (i.e., occurrence of aSAH): current (within 3 months), recent (3-12 months), and past (>12 months). A logistic regression model was fitted to compare drug use across these exposure windows vs never use, controlling for age, sex, known aSAH risk factors, and health care utilization. The family-wise error rate was kept at p < 0.05 through Bonferroni correction. We investigated exposure to 205 commonly prescribed drugs between 4,879 aSAH cases (mean age 61.4, 61.2% women) and 43,911 matched controls. We found similar trends for lisinopril and amlodipine, with a decreased aSAH risk for current use (lisinopril odds ratio [OR] 0.63, 95% CI 0.44-0.90, amlodipine OR 0.82, 95% CI 0.65-1.04) and an increased aSAH risk for recent use (lisinopril OR 1.30, 95% CI 0.61-2.78, amlodipine OR 1.61, 95% CI 1.04-2.48). A decreased aSAH risk in current use was also found for simvastatin (OR 0.78, 95% CI 0.64-0.96), metformin (OR 0.58, 95% CI 0.43-0.78), and tamsulosin (OR 0.55, 95% CI 0.32-0.93). By contrast, an increased aSAH risk was found for current use of warfarin (OR 1.35, 95% CI 1.02-1.79), venlafaxine (OR 1.67, 95% CI 1.01-2.75), prochlorperazine (OR 2.15, 95% CI 1.45-3.18), and co-codamol (OR 1.31, 95% CI 1.10-1.56). We identified several drugs associated with aSAH, of which 5 drugs (lisinopril and possibly amlodipine, simvastatin, metformin, and tamsulosin) showed a decreased aSAH risk. Future research should build on these signals to further assess the effectiveness of these drugs in reducing aSAH incidence. This study provides Class III evidence that some commonly prescribed drugs are associated with subsequent development of aSAH.

The impact of family history of mental illness on mental health help seeking in university students

Background University students with a family history of mental illness may have an increased risk of developing mental health problems. Aims The aim of the study was to assess differences in mental health help seeking among students with a family history of mental illness compared to those without a family history. Methods A total of 1127 university students, aged 18 to 30 years, completed an online survey with questions about mental illness, family history of mental illness, help seeking, and psychological symptoms. Results Students with a family history of mental illness were more likely to report clinically significant symptoms and more likely to use social media and online support programs. They reported similar rates of in-person help seeking. Those with more than one family member with a mental illness reported greater symptom severity, more use of online programs, and increased likelihood of prescription drug use than those with only one family member. Conclusions More research is needed to understand how to increase access to mental health care and to address barriers to help-seeking considering family history of mental illness. University students may not be accessing appropriate treatment and care as required, with the rates of in-person help-seeking being low overall.

Characterising individuals with a substance use disorder accessing hospital-based addiction care: Preliminary description of the outcomes for patients accessing addiction care prospective cohort study.

Individuals with a substance use disorder (SUD) often face barriers to accessing health care, resulting in unmet needs and delayed care. Hospital-based services have the potential to engage individuals with a SUD in ongoing treatment, but there is limited literature characterising this population. The Outcomes for Patients Accessing Addiction Care study was a prospective hospital-based cohort study conducted at St. Paul's Hospital in Vancouver, Canada. Participants were recruited from January 2018 to March 2020. Data were collected through an interviewer-administered questionnaire, including socio-demographic information, substance use history and mental health screening. The cohort included 536 participants, with 31% aged 30-39 years, 63% identifying as White and 74% reporting male sex at birth. Nearly half of the participants were either homeless or living in single room occupancy. Use of substances more than once per week was reported for tobacco/nicotine (86%), marijuana (43%), non-medical use of prescription drugs (29%), illicit stimulants (52%) and illicit opioids (61%). This preliminary report provides a description of a hospital-based cohort of individuals with a SUD accessing addiction care. The findings highlight demographic characteristics, mental health issues, substance use patterns and barriers to accessing services. Understanding these factors can inform the development of patient-centred interventions and improve engagement and retention in addiction care. Further research is needed to explore interventions and program effectiveness in this population.

Factors associated with the use of benzodiazepine and opioid prescription drug in the student population: a cross-sectional study

The misuse of benzodiazepines and opioid medications is frequent in students. To improve our understanding of this behavior, we aimed to identify factors associated with separate and concomitant use of these substances. Anonymous self-reported questionnaires were e-mailed to students enrolled at a French university between March and July 2021, covering: sociodemographic characteristics, academics, psychoactive substance use, ADHD symptomatology (adulthood and childhood), and psychiatric/psychological or addiction follow-up. Factors associated with the use of benzodiazepines and opioid medications included female sex (OR = 1.41 [1.08; 1.86]) and OR = 1.38 [1.06; 1.79], respectively), older age (OR = 1.65 [1.04; 2.6] and OR = 2.17 [1.4; 3.36], respectively), current psychiatric/psychological follow-up (OR = 6.53 [5.18; 8.24] and OR= 1.5 [1.12; 2.0], respectively), ADHD symptomatology (OR= 2.33 [1.71;3.16] and OR= 1.61 [1.15; 2.24], respectively), polyconsumption (tobacco use for benzodiazepine users, OR = 1.38 [1.04; 1.82]; alcohol use OR = 1.67 [1.17; 2.39] and tobacco use OR = 1.62 [1.23; 2.14] for opioid users). These factors were even more strongly associated with the concomitant use of benzodiazepines and opioid medications: older age (OR = 3.64 [2.22; 5.99]), female sex (OR = 1.54 [1.1; 2.14]), grade repetition (OR = 1.7 [1.14; 2.54]), psychiatric/psychological follow-up (OR = 4.51 [3.35;6.06]), ADHD symptomatology (OR = 5.3 [3.69; 7.63]), polyconsumption (tobacco use OR = 2.05 [1.39; 3] and cannabis use, OR = 2.07 [1.97; 4.16]. The factors associated with the use of benzodiazepines and prescription opioids identified in this study could lead to the development of targeted prevention methods.

Retrospective evaluation of drug to drug interactions with paclitaxel use in military health.

e24118 Background: Paclitaxel is an antineoplastic agent used in the management of multiple metastatic and non-resectable tumor types approved for ovarian, breast, AIDS-related Kaposi sarcoma, non-small cell lung, pancreatic, cervical, endometrial, and thymoma or thymic carcinoma cancer by the US Food and Drug Administration. Cytochrome P450 (CYP) 3A4 or 2C8 inducers, inhibitors, or substrates may alter paclitaxel metabolism. Because DDIs can have an effect on clinical outcomes, we aimed to identify drugs that interact with paclitaxel and describe their clinical manifestations. Methods: A retrospective analysis was performed on the health records of patients in the US Department of Defense Cancer Registry (retrieved March 2022), Comprehensive Ambulatory/Professional Encounter Records, and Pharmacy Data Transaction Service database (both retrieved October 2022). Patients’ medical history, diagnoses, and demographics were extracted and analyzed for differences in adverse effects when these agents were used alone vs concomitantly with other prescription drugs. Patients’ diagnoses and prescription drug use were extracted to compare completed vs discontinued treatment groups, identify medications commonly co-administered with paclitaxel, and evaluate DDIs with antidepressants. Results: Of 702 patients using paclitaxel, 338 completed treatments. The P value for paclitaxel discontinuation when used alone vs concomitantly or 1 drug (alone or before or after) vs combination (2 to 4 drugs) was &lt; .001. Patients who took paclitaxel concomitantly with a greater number of prescription drugs had a higher rate of treatment discontinuation than those who received fewer medications. Patients in the completed group received 9 to 56 prescription drugs, and those in the discontinued group were prescribed 6 to 70. Those who discontinued treatment had more diagnosed medical issues than those who completed treatment. Conclusions: This review cannot conclude that concomitant use with prescription drug(s) resulted in paclitaxel discontinuation. There were no significant DDIs determined between paclitaxel and antidepressants.[Table: see text]

A retrospective cohort study of prescription drug use among youth with intellectual/developmental disabilities in British Columbia.

People with intellectual/developmental disabilities (IDD) are known to have high rates of prescription drug use, particularly for psychotropic medications. This is of concern due to the many side effects associated with these medications and because of the risks of polypharmacy. In this paper we compare the most commonly dispensed drugs and all psychotropic medications for youth with IDD compared with youth without IDD. Using population-level administrative health data over a 10-year period, this study examined medications dispensed to youth with an IDD aged 15-24years compared with youth without an IDD. The most common medications dispensed and the number of youth they were dispensed to were determined. As well a wide variety of psychotropic medications were examined. There were a total of 20591 youth with IDD and 1293791 youth without IDD identified. Youth with IDD had higher odds of being dispensed pain medications, amoxicillin, salbutamol, levothyroxine and all the psychotropic medications (antidepressants, antipsychotics, anxiolytics, anti-adrenergic agents, mood stabilisers and stimulants). For youth with IDD, 6558 (31.85%) were dispensed two or more different psychotropic medications within a year, compared with 75963 (5.87%) of youth without IDD. Compared to youth without IDD, youth with IDD had significantly higher odds of being dispensed most of the prescription medications studied, including all of the psychotropic medications. They were also twice as likely to be dispensed two or more medications from different classes of psychotropic drugs within the same year. These findings have important implications for the health of people with IDD and for their health care providers.

Mental health and use of psychotropic prescription drugs in adult patients with primary immune thrombocytopenia: a nationwide population-based cohort study.

Patients with primary immune thrombocytopenia (ITP) suffer from reduced survival and quality of life, but the underlying reasons for this are largely undescribed. Mental health and the use of psychotropic drugs in ITP is unknown. We investigated the risk of hospital-registered mental health events including fatigue and the use of psychotropic drugs in adult patients with ITP compared with the general population, using nationwide registry-data. We identified 3,749 patients with ITP and 149,849 age- and sex-matched general population comparators in the Danish Health Registries in the period 1997-2016. The median age was 60 years (interquartile range [IQR], 40-73) and 53% were women. We followed the individuals for incident mental health events and estimated the use of psychotropic drugs over calendar-years and in temporal relation to diagnosis of ITP. The first year cumulative incidence of any mental health event was 2.3% (95% confidence interval [CI]: 1.9-2.9) in patients and 0.7% (95% CI: 0.6-0.7) in comparators, yielding an adjusted cause-specific hazard ratio (csHR) of 3.57 (95% CI: 2.84-4.50). The corresponding estimates for depression were 1.2% (95% CI: 0.9-1.6) and 0.3% (0.3-0.4) respectively, with an adjusted csHR of 3.53 (95% CI: 2.56-4.85). We found similar findings for anxiety and fatigue, but risks generally diminished after 1-5 years. The use of opioids, antidepressants, and benzodiazepines increased in temporal relation to diagnosis of ITP. The risk of mental health events and the use of psychotropic drugs is higher in adult patients with ITP compared with the general population, and has a temporal relation to diagnosis of ITP emphasizing that mental health in ITP is a concern.

Association of Opioid and Concurrent Benzodiazepine, Skeletal Muscle Relaxant, and Gabapentinoid Usage on Healthcare Expenditure and Resource Utilization: A Serial Cross-Sectional Study, 2009 to 2019.

Healthcare providers may be utilizing central nervous system (CNS) depressants to reduce opioid use due to recent changes in public policy. Combination use of these agents with opioids increases the risk of respiratory depression and death. Healthcare expenditures by individuals using these drug combinations have not been previously quantified. We sought to characterize healthcare costs and expenditures associated with a population reporting concurrent CNS depressants and opioid use compared with nonopioid analgesics in the United States from 2009 to 2019. A serial cross-sectional design was used to compare the healthcare expenditures of adult Medical Expenditure Panel Survey respondents who were prescribed nonopioid analgesics, opioids only, opioids/benzodiazepines (BZD), opioids/BZD/skeletal muscle relaxants (SMR), or opioids/gabapentin (gaba) using pooled data from 2009 to 2019. Expenditure (cost and resource utilization) categories included inpatient, outpatient, office-based, and prescription medicine. Average marginal effects were used to compare survey-weighted annual costs and resource utilizations across the groups as compared to nonopioid analgesic respondents, adjusted for covariates. A weighted total of 34 241 838 individuals were identified. Most were opioid-only respondents (46.5%), followed by nonopioid analgesic (43.4%), opioid/BZD (5.3%), opioid-gaba (3.5%), and opioid/BZD/SMR respondents (1.3%). In comparison to the study groups with nonopioid analgesics, opioid-gaba users had the highest significant incremental cost difference among the different pairings (+$11 684, P < .001). Opioid-gaba, opioid/BZD, and opioid/BZD/SMR respondents had significantly higher inpatient, emergency department, and prescription drug costs and use compared to nonopioid analgesic respondents. Opioid-only respondents had higher outpatient and office-based costs and visits compared to nonopioid analgesic respondents. As healthcare providers seek to utilize fewer opioids for pain management, attention must be paid to ensuring safe and effective use of concurrent CNS depressants to mitigate high healthcare costs and burden.

Prescription medication use among patients with type 2 diabetes in the United States: 1999-2020.

We aimed toexamine trends in overall prescription medication use among patients with type 2 diabetes in the United States to provide insights for patient care. We used nationally representative data from the National Health and Nutrition Examination Survey from 1999 to 2020 and included adult patients with type 2 diabetes. We examined the use of prescription drugs, overall and by drug class, polypharmacy (use of ≥5 medications), and number of medications attributed to specific classes. In the period 2015-2020, the mean patient age was 59.6 (51.0-70.0) years, with 46.8% (43.6-49.9) being female and 57.8% (52.8-62.8) being non-Hispanic White. Among 9489 adults with type 2 diabetes, the prevalence of polypharmacy was high and increased from 35.1% (31.6-38.6) in 1999-2002 to 47.2% (43.7-50.7) in 2003-2006, and further to 51.1% (48.3-53.9) in 2015-2020 (p for trend <0.001). Increasing trends of polypharmacy were found across all population subgroups and across the majority of therapeutic classes. Use of non-cardiometabolic medications was common. Among them, the most common were antidepressants (19.8%), proton pump inhibitors (19.0%) and analgesics (16.2%). Among patients with polypharmacy, approximately 40% of medication use was attributed to non-cardiometabolic medications. Prescription medication burden and complexity increased substantially among patients with type 2 diabetes, with more than 50% of patients with polypharmacy. Attention should be paid to this escalating medication use and regimen complexity, which requires multidisciplinary and coordinated care.

Information Technology, Improved Access, and Use of Prescription Drugs

Abstract We estimate the effects of health information technology designed to improve access to medication while limiting overuse through easier prescription renewal and improved information provision. We focus on benzodiazepines, a commonly prescribed class of mental health and insomnia medications, which are highly effective but potentially addictive. We study the staggered rollout of a nationwide electronic prescribing system over four years in Finland and use population-wide, individual-level administrative data sets. We find that e-prescribing increases average benzodiazepine use due to increased prescription renewals. The increase is most pronounced for younger patients. E-prescribing can improve the health of elderly patients and may help to balance the access-overuse trade-off. Without additional monitoring for addiction in place, it may, however, also have unintended health consequences for younger patients, who are more likely to develop mental and behavioral health disorders.

Prescription and Non-Prescription Drug Use during the Covid-19 Pandemic among Racial-Ethnic Identities

Prescription and Non-Prescription Drug Use during the Covid-19 Pandemic among Racial-Ethnic Identities

Predictors, motives, sources and patterns of nonmedical use of prescription drugs among youths in Buea, Southwest region of Cameroon: A mixed method analysis

BackgroundThe non-medical use of prescription drugs (NMUPD) is an emerging phenomenon of serious public health concern among young people globally. This study seeks to determine the predictors, motives, sources, patterns of use of NMUPD among youths in the Buea Health District of the South west region. Materials and MethodsA mixed-method community-based, cross-sectional study conducted from May to June 2018, enrolled participants aged 15 - 29 years from schools and community. A pretested semi-structured questionnaire was used to capture data and focus group discussions and key informant interviews were conducted. Quantitative and qualitative analyses were performed with SPSS version 24 and ATLAS.ti version 7 respectively. Logic regression analysis were carried at 5 % significance level. ResultsThe study enrolled 464 participants (median age of 21 years, IQR: 18 – 23.8 years) into the quantitative study, 63 % were females. Forty-nine participants were enrolled for the qualitative study. A total of 90 (19.6 %; CI: 15.9 – 23.3 %) participants accepted they have used prescriptions medications in the last 12 months for non-medical purposes. Opioids (74.4 %) particularly tramadol (60.1 %) were the most common drugs used. Male gender (p = 0.001), the age group 20–24-year, smoking (p = 0.043) and use of illicit substances (p < 0.001) were independent predictors of NMUPD. Prominent motivations were:- curiosity (31.1 %) and enhancement of work performance (30 %). Unregistered pharmacies and private health facilities were the main sources of these drugs which are acquired mainly without prescription. ConclusionMale gender, young adults, smoking and use of illicit substances were independent predictors of NMUPD. Motives were hinged to enhancement of performance in various domains of social life. Opioids, particularly tramadol was the predominant drug used, acquired without prescription from unregistered pharmacies. Findings of this study provide baseline evidence that could guide policies on drug prevention, treatment and harm reduction interventions.