Trends in Prescription Medication Use Among Children and Adolescents-United States, 1999-2014

IMPORTANCE Access to appropriate prescription medications, use of inappropriate or ineffective treatments, and adverse drug events are public health concerns among US children and adolescents. OBJECTIVE To evaluate trends in use of prescription medications among US children and adolescents. DESIGN, SETTING, AND PARTICIPANTS US children and adolescents aged 0 to 19 years in the 1999-2014 National Health and Nutrition Examination Survey (NHANES)serial cross-sectional, nationally representative surveys of the civilian noninstitutionalized population. EXPOSURES Sex, age, race and Hispanic origin, household income and education, insurance status, current health status. MAIN OUTCOMES AND MEASURES Use of any prescription medications or 2 or more prescription medications taken in the past 30 days; use of medications by therapeutic class; trends in medication use across 4-year periods from 1999-2002 to 2011-2014. Data were collected though in-home interview and direct observation of the prescription container. RESULTS Data on prescription medication use were available for 38 277 children and adolescents (mean age, 10 years; 49% girls). Overall, use of any prescription medication in the past 30 days decreased from 24.6%(95% CI, 22.6% to 26.6%) in 1999-2002 to 21.9% (95% CI, 20.3% to 23.6%) in 2011-2014 (beta = -0.41 percentage points every 2 years [95% CI, -0.79 to -0.03]; P =.04), but there was no linear trend in the use of 2 or more prescription medications (8.5%[95% CI, 7.6% to 9.4%] in 2011-2014). In 2011-2014, the most commonly used medication classes were asthma medications (6.1%[95% CI, 5.4% to 6.8%]), antibiotics (4.5%[95% CI, 3.7% to 5.5%]), attention-deficit/hyperactivity disorder (ADHD) medications (3.5%[95% CI, 2.9% to 4.2%]), topical agents (eg, dermatologic agents, nasal steroids) (3.5%[95% CI, 3.0% to 4.1%]), and antihistamines (2.0% [95% CI, 1.7% to 2.5%]). There were significant linear trends in 14 of 39 therapeutic classes or subclasses, or in individual medications, with 8 showing increases, including asthma and ADHD medications and contraceptives, and 6 showing decreases, including antibiotics, antihistamines, and upper respiratory combination medications. CONCLUSIONS AND RELEVANCE In this study of US children and adolescents based on a nationally representative survey, estimates of prescription medication use showed an overall decrease in use of any medication from 1999-2014. The prevalence of asthma medication, ADHD medication, and contraceptive use increased among certain age groups, whereas use of antibiotics, antihistamines, and upper respiratory combination medications decreased.