Results published on 10 December in the latest Health Survey for England show that 50% of women and 43% of men reported taking at least one prescribed medicine in the past week. 22% of men and 24% of women reported taking at least three prescribed medicines in the past week.
The Health Survey for England is an annual survey that monitors the health of the population, conducted by researchers from UCL and NatCen Social Research for the Health & Social Care Information Centre (HSCIC). The latest publication reports on prescribed medicines using combined data from the 2012 and 2013 surveys.
Prescribed medicine use rose with age, with more than half of participants aged 65-74 and more than 70% of those aged 75 and over taking at least three prescribed medicines. Approximately half of men aged 65 and above were taking cholesterol-lowering medicines such as statins.
“This is the first nationally-representative study to report on the use of prescribed medicines taken by people in the community, not just those within the healthcare system,” says study author Dr Jennifer Mindell (UCL Epidemiology & Public Health). “That half of men over 65 are taking cholesterol-lowering medicines reflects the high risk of cardiovascular disease in this group. When the surveys were conducted, these medicines were offered to patients who already had heart disease, stroke, diabetes, high blood pressure needing treatment, or a 20% risk of developing cardiovascular disease in the next 10 years. Stopping smoking, being a healthy weight, eating more vegetables and fruit, and being physically active reduce people’s risk of these diseases, for people who want to avoid taking medicines.”
The guidelines for cholesterol-lowering medicines were updated this year to include people with a 10% or greater risk of heart disease, so the proportion of people taking such medicines may increase over the coming years.
While cholesterol-lowering medicines were more common among men, antidepressants were taken by around 11% of women compared with 5.5% of men. Antidepressant use was most common among middle-aged women, with 16% of 45-64 year old women reporting taking them. There was also a significant gap between rich and poor, with 17% of the nation’s poorest women reporting taking antidepressants compared with 7% of the richest.
“It’s well known that rates of depression are much higher among women than men, so I am not surprised to see that antidepressant use follows the same pattern in this study,” says Dr Sarah Jackson (UCL Epidemiology), a research psychologist who was not involved in the study. “The high number of low-income women on antidepressants could be down to a number of factors. People with depression are less likely to be in regular employment, and people who are unemployed or in low paid jobs are more likely to have depression. It may also be that depression is being identified and treated more frequently in people from lower income groups who are seeing their doctor for the other health conditions. Many health conditions that are more common among low-income groups, such as obesity, are also strongly linked with depression.”
Higher BMI was also linked to greater medicine use, with more than half of more severely obese participants (BMI 35kg/m2 or more) reporting taking at least one prescribed medicine and a third of them taking three or more. Many had been prescribed painkillers, antidepressants, medicines to lower cholesterol, and/or medicines to reduce blood pressure.
“This study shows that obesity is strongly linked with increased use of prescribed medicines and for the first time allows us to quantify this in a nationally-representative sample,” explains study co-author Sue Faulding, Pharmacist & Programme Manager of Prescribing and Primary Care Services at the HSCIC. “Obesity is often associated with high cholesterol, high blood pressure, joint pain and depression. Lifestyle changes are always recommended in the first instance, but medicines can help to address the symptoms and this study shows that medicine use increases steadily with BMI.
“Prescribing data from General Practices can tell us what has been prescribed but not what patients actually take. It is reassuring to see the findings in the HSE study aligns with those from national data. For example we knew that older people are prescribed more medicines particularly for cardiovascular disease and that lipid lowering medicines are the most commonly prescribed. The rates of use of diabetes medicines and antihypertensive medicines seen here align with the prevalence rates for diabetes and hypertension reported in the Quality Outcomes Framework (QOF).
“This HSE study validates our dispensing data and helps to further contextualise the results. The additional new information about the impact of a wider range of factors on prescribing and use of medicines provides valuable evidence that will enable us to better inform and advise national bodies such as the National Institute for Health and Care Excellence (NICE) on how prescribed medicines are used in this country, and by whom.”
Source: UCL (University College London)