Cargando…

Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients

BACKGROUND: Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs), which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the...

Descripción completa

Detalles Bibliográficos
Autores principales: Anda, Robert F, Brown, David W, Felitti, Vincent J, Dube, Shanta R, Giles, Wayne H
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440750/
https://www.ncbi.nlm.nih.gov/pubmed/18533034
http://dx.doi.org/10.1186/1471-2458-8-198
_version_ 1782156571709538304
author Anda, Robert F
Brown, David W
Felitti, Vincent J
Dube, Shanta R
Giles, Wayne H
author_facet Anda, Robert F
Brown, David W
Felitti, Vincent J
Dube, Shanta R
Giles, Wayne H
author_sort Anda, Robert F
collection PubMed
description BACKGROUND: Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs), which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce. METHOD: We used the ACE Score (an integer count of 8 different categories of ACEs) as a measure of cumulative exposure to traumatic stress during childhood. We prospectively assessed the relationship of the Score to prescription drug use in a cohort of 15,033 adult HMO patients (mean follow-up: 6.1 years) and assessed mediation of this relationship by documented ACE-related health and social problems. RESULTS: Nearly 1.2 million prescriptions were recorded; prescriptions rates increased in a graded fashion as the ACE Score increased (p for trend < 0.0001). Compared to persons with an ACE Score of 0, persons with a Score ≥ 5 had rates increased by 40%; graded relationships were seen for all age groups (18–44, 45–64, and 65–89 years) (p for trend < 0.01). Graded relationships were observed for the risk of being in the upper decile of number of classes of drugs used; persons with scores of ≥ 5 had this risk increased 2-fold. Adjustment for ACE-related health problems reduced the strength of the associations by more than 60%. CONCLUSION: ACEs substantially increase the number of prescriptions and classes of drugs used for as long as 7 or 8 decades after their occurrence. The increases in prescription drug use were largely mediated by documented ACE-related health and social problems.
format Text
id pubmed-2440750
institution National Center for Biotechnology Information
language English
publishDate 2008
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-24407502008-06-27 Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients Anda, Robert F Brown, David W Felitti, Vincent J Dube, Shanta R Giles, Wayne H BMC Public Health Research Article BACKGROUND: Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs), which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce. METHOD: We used the ACE Score (an integer count of 8 different categories of ACEs) as a measure of cumulative exposure to traumatic stress during childhood. We prospectively assessed the relationship of the Score to prescription drug use in a cohort of 15,033 adult HMO patients (mean follow-up: 6.1 years) and assessed mediation of this relationship by documented ACE-related health and social problems. RESULTS: Nearly 1.2 million prescriptions were recorded; prescriptions rates increased in a graded fashion as the ACE Score increased (p for trend < 0.0001). Compared to persons with an ACE Score of 0, persons with a Score ≥ 5 had rates increased by 40%; graded relationships were seen for all age groups (18–44, 45–64, and 65–89 years) (p for trend < 0.01). Graded relationships were observed for the risk of being in the upper decile of number of classes of drugs used; persons with scores of ≥ 5 had this risk increased 2-fold. Adjustment for ACE-related health problems reduced the strength of the associations by more than 60%. CONCLUSION: ACEs substantially increase the number of prescriptions and classes of drugs used for as long as 7 or 8 decades after their occurrence. The increases in prescription drug use were largely mediated by documented ACE-related health and social problems. BioMed Central 2008-06-04 /pmc/articles/PMC2440750/ /pubmed/18533034 http://dx.doi.org/10.1186/1471-2458-8-198 Text en Copyright © 2008 Anda et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Anda, Robert F
Brown, David W
Felitti, Vincent J
Dube, Shanta R
Giles, Wayne H
Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
title Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
title_full Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
title_fullStr Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
title_full_unstemmed Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
title_short Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
title_sort adverse childhood experiences and prescription drug use in a cohort study of adult hmo patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440750/
https://www.ncbi.nlm.nih.gov/pubmed/18533034
http://dx.doi.org/10.1186/1471-2458-8-198
work_keys_str_mv AT andarobertf adversechildhoodexperiencesandprescriptiondruguseinacohortstudyofadulthmopatients
AT browndavidw adversechildhoodexperiencesandprescriptiondruguseinacohortstudyofadulthmopatients
AT felittivincentj adversechildhoodexperiencesandprescriptiondruguseinacohortstudyofadulthmopatients
AT dubeshantar adversechildhoodexperiencesandprescriptiondruguseinacohortstudyofadulthmopatients
AT gileswayneh adversechildhoodexperiencesandprescriptiondruguseinacohortstudyofadulthmopatients