Recent Patterns of Medication Use in the Ambulatory Adult Population of the United States

Abstract

A large number and wide variety of medications approved for use by the US Food and Drug Administration (FDA) are available to the US population, and expenditures on drugs have increased dramatically in recent years.^1-3 New prescription drugs are continually introduced, and older drugs are increasingly available over the counter (OTC), making self-medication commonplace. Adverse reactions to drugs are among the leading causes of hospitalization and death in this country.^4,5 At the same time, there has been a considerable increase in the use of herbal products and other natural supplements^6,7 (henceforth referred to as "herbals/supplements"), which by law are not subject to FDA regulation. Although these products may be taken concurrently with regulated medications, health care professionals are often not informed of such use by their patients.⁷ Evidence is growing that many herbals/supplements have pharmacologic activity that can lead to clinically serious adverse interactions when they are taken together with regulated drugs,⁸ but there is little information available to estimate the potential magnitude of this problem.