We are a nation addicted to prescription drugs of one sort or another. But we seldom take them exactly as they were prescribed, and we endure a lot of adverse effects. Online information about prescription medications has been, as you would expect, both a blessing and a curse.

This is the conclusion I draw from iGuard.org’s publication of a white paper on prescription drug trends in the US. iGuard is a service that helps patients monitor drug safety, publishes alerts, and clearly collects data. Some of the data in the white paper is their own, and the rest comes from respected sources.

Nearly half of all Americans take at least one prescription drug and one in six Americans takes three or more medications. (SOURCE: Institute of Medicine (IOM) 2007. The Future of Drug Safety: Promoting and Protecting the Health of the Public, Washington DC: National Academies Press)
• 32 million Americans are taking three or more medications daily. (SOURCE: American Heart Association;http://home3/tapslhi/public_html/vitalysthealth/.americanheart.org/presenter.jhtml?identifier=107)
• Prescription drug use is rising among people of all ages, and use increases with age with five out of six persons 65 and older taking at least one medication and almost half the elderly taking three or more. SOURCE: CDC National Center for Health Statistics: Health, United States 2004 – 12/2(S/04

The top classes of drugs for all patients in July 2008 included:
1. Codeine, alone and in combination (typically with acetaminophen)
2. Statins (cholesterol-lowering, simvastatin, atorvastatin)
3. Beta Blockers (heart drugs)
4. SSRI antidepressants (e.g., Lexipro, Celexa, Prozac, Zoloft, Paxil)
5. ACE Inhibitors (hypertension, Lisinopril)
6. Seizure disorders (used for epilepsy as well as migraines (Topamax), bipolar disorder (Lamictal), and pain (Lyrica, neurontin)
7. Thyroid medications
8. PPIs for ulcers, GERD (e.g., Nexium, Aciphex, Prevacid)
9. Benzodiazepines (anxiety – Xanax, Valium)
10. Calcium channel blockers (hypertension)

The top classes of drugs that children from ages 0-17 are taking include:
1. Analeptics (medications for ADHD)
2. Aminopenicillins (antibiotics)
3. Cephalosporn (antibiotics)
4. Leukotriene agents (Singulair, allergy & asthma)
5. Corticoids, dermatological (topical steroids)
6. Macrolides (antibiotics)
7. Beta Agonist Aerosol (e.g., albuterol)
8. Codeine and combination
9. Oral corticoids (oral steroids)
10. Antibiotic drops for the ear

You can see that kids get a lot of antibiotics and asthma meds. Adults get a lot of pain-killers (physical and emotional). This costs the health care system big bucks.

• More than half (53%) of all consumers go online to look for prescription drug information, vs. 41% in 2007 (SOURCE: 11th annual national survey, “Consumer Reaction to DTC Advertising of Prescription Medicines,” conducted by Prevention, Men’s Health and Women’s Health magazines, with technical assistance from the FDA. The study is one of the primary consumer studies informing the FDA’s stance on Direct-to-Consumer (DTC) issues. 6/10/08)
• The same Prevention study reported that of those taking prescription medicines, 55% saw an advertisement for the medicine they were taking. “Consumers are firmly rooted in the era of online health management as more and more patients embrace tools and trackers such as Google, Yahoo and Revolution Health,” said Cary Silvers, Director of Consumer Insights at Rodale, who spearheaded the 2008 study. “Along with the doctor and pharmacist, the online component has become the third leg of the stool as consumers learn about drugs. The more consumers know, the more likely they are to take action.”

But then the information gets ugly. The number one problem doctors report about treating patients is failure to take prescription medications correctly, regardless of patient age. Most Americans receive the prescriptions they need, but either don’t fill them, don’t finish them, or don’t take them correctly. More than half of Americans with chronic diseases don’t follow their physicians’ advice. People go so far as to fill their prescriptions and then fail to take ANY of the medicines.

These are big public health problems. We are throwing money spent on pharmaceuticals — and it’s something over $100 billion a year — down the toilet. The wrong people are taking the drugs — the sick don’t take them, and the lifestyle experimenters and addicts do.

Many people don’t take their drugs because of adverse events. They are beginning to report those online in patient forums and to the FDA, but not nearly in the numbers they should for the information to be effective. However, in 2006, consumers replaced physicians as the largest source of adverse event reporting to the FDA.

Consumers need to be encouraged to report adverse events that aren’t serious enough to hospitalize them but are enough to make them stop taking a medication, or the FDA can’t do its aftermarket surveillance properly. iGuard’s own member data reports that 25% of its diabetic members are taking medications with a risk rating of 4 out of a possible 5.

As consumers, we can fix this system if we each contribute our own experience. It’s called crowd-sourcing, and it’s very valuable.