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Health Related Actions: Use of Medication
Expenditure on medication
Expenditure on medication by both government and private sectors represents a substantial proportion of the recurrent health expenditure in Australia (12% in 1994-95). In 1994-95 the total expenditure on medication was over $4,200 million, an increase of 12% from the previous year and 53% since 1990-91. Over half of this expenditure (51%) was by the private sector, almost entirely by individuals, and nearly half was by the Commonwealth government, largely through the Pharmaceutical Benefits Scheme (PBS).
The increase in expenditure on medication is related to a variety of factors including the rising costs of medications, increases in the of people using medication, such as the elderly.
The social or indirect costs associated with the inappropriate use of medication include avoidable hospital admissions and unnecessary follow-up visits to doctors. These costs can result from the abuse, over-use or under-use of medication; individual hypersensitivity reactions from the prolonged or frequent use of particular medications; or adverse side effects from the concurrent use of two or more specific types of medication.
Who uses medication?
In 1995 nearly 12.5 million Australians (69%) had recently (in the two weeks prior to being interviewed) used at least one medication, 59% had used a prescribed or non-prescribed medication, 26% had used a vitamin or mineral supplement, and 9% a natural medication.
The proportion of people using medication increased with age from 51% of those aged 0-14 to 88% for those aged over 54. Age was also a factor determining the types of medications used. The most common medications used by people aged 0-14, 15-34 and 35-54 were vitamin and mineral supplements (16%, 27%, and 31% respectively) and pain relievers (14%, 27%, and 29%). These were followed by medications for coughs and colds for those aged 0-14, skin ointments and creams for those aged 15-34, and natural medications for those aged 35-54. The most common medications used by people aged over 54 were medications for heart and blood pressure (43%), followed by vitamin and mineral supplements, and pain relievers.
Overall, a higher proportion of females than males had recently used a medication. Prescribed or non-prescribed medications were used by 64% of females and 54% of males. Vitamin and mineral supplements were used by 30% of females and 21% of males and natural medications were used by 12% of females and 7% of males.
For all age groups most of the specific types of medications were more likely to have been used by females than males. However, for certain medications, and age groups, medication use by males was greater than by females. For example, in the 0-14 age group, males were more likely than females to have recently used an asthma medication (9.2% compared to 7.2%). This reflects the higher prevalence of males with asthma in this age group (18% compared to 14%). In addition, of those aged 35-54, males were more likely to have used medication for cholesterol (2.1% compared to 0.7%) reflecting the higher prevalence of males with high cholesterol in this age group (8% compared to 5% of women).
Prescribed and non-prescribed medication
In 1995, 36% of the population had recently used a prescribed medication and 35% had used a non-prescribed medication. Of the population using a non-prescribed medication, 36% stated that at least one of the non-prescribed medications was used on the advice of a health professional.
The use of prescribed medication increased from 20% for those aged 0-14 to 71% for those aged over 54. The use of non-prescribed medication increased from 28% for those aged 0-14 to peak at 39% for those aged 15-34 and 35-54 and then decreased to 30% for those aged over 54. Males were equally likely to have used a prescribed medication as a non-prescribed medication (32% each). Women, though, were more likely to have used a prescribed medication than a non-prescribed medication (41% compared to 37%).
A substantial proportion of the population had used two or more medications that were prescribed or non-prescribed (31%). 12% had used both types of medications. The proportion of people using two or more prescribed medications (19%) was more than double the proportion using two or more non-prescribed medications (9%). This most likely reflects the type of condition (or symptom) for which these medications were being used. Non-prescribed medications were most commonly used to treat acute symptoms, whereas prescribed medications were most commonly used to treat more chronic conditions.
For example, the most commonly used non-prescribed medications were pain relievers (20% of people), the majority of which (60%) were used to treat headaches due to unspecified or minor causes. Other commonly used non-prescribed medications were skin ointments or creams (6%), and medications for cough or colds (5%). The most commonly used prescribed medications were heart or blood pressure medications (11% of people), asthma medications (6%) and pain relievers (4%).
Prescribed medications were four times more likely than non-prescribed medications to be used on a daily basis. Medications most commonly used on a daily basis were medications for diabetes, medications to reduce serum lipids, heart and blood pressure medications, fluid or diuretic medications, and medications for anxiety depression or nervous condition (in over 90% of cases). Medications least likely to be used on a daily basis were medications for pain relief and allergy medication (17% and 30% respectively).
PROPORTION OF THE POPULATION USING A PRESCRIBED OR NON-PRESCRIBED MEDICATION BY THE SPECIFIC TYPE OF MEDICATION(a), 1995
(b) People may have reported using more than one type of medication, therefore components do not add to the total.
Source: Unpublished data, 1995 National Health Survey.
Vitamin and mineral supplements and natural medications
In 1995, 30% of the population had recently used a vitamin and mineral supplement, or a natural medication. People aged 45-54 were more likely than any other age group to have used a vitamin and mineral supplement, or natural medication (37%), while those aged 0-14 were the least likely (18%).
The primary purpose of using prescribed or non-prescribed medications is to treat a specific health condition. In contrast, people use vitamins and mineral supplements and natural medications generally, as a preventative health measure: 82% of those using a vitamin and mineral supplement and 70% of those using a natural medication did so to prevent illness rather than to treat a pre-existing medical condition.
Following preventative reasons, the next most common reason stated for using a vitamin and mineral supplement or natural medication was to treat a disease of the respiratory system (6%). Of these, 40% stated that they were used specifically to treat the common cold. The next most common reason stated was to treat a disease of the musculo-skeletal system and connective tissue (4%). Of these, 63% stated that they were specifically used to treat arthritis.
PEOPLE USING VITAMIN OR MINERAL SUPPLEMENTS, OR NATURAL MEDICATIONS(a), 1995
(b) People may have reported using vitamin and mineral supplements or natural medications for preventative health reasons and to treat a specific health condition, therefore components will not add to the totals.
Source: Unpublished data, 1995 National Health Survey.