Objective: To examine the self-reported use of over-the-counter (OTC) medications and the factors associated with OTC use in a rural older population.
Design: A cross-sectional study of an age-stratified random community sample.
Setting: The mid-Monongahela Valley, a rural area of Southwestern Pennsylvania.
Participants: A total of 1059 older individuals with a mean age of 74.5 (+/- 5.5) years, 96.9% of whom were white and 57.3% of whom were women.
Measurements: Self-reported over-the-counter drug use and demographic information, and information about prescription drug use and recent use of health services.
Results: The majority (87.0%) of the sample were taking at least one OTC medication; 5.7% reported taking five or more OTCs. Women took significantly more OTCs than did men (P < .001). Individuals with more education took significantly more OTCs than those who had less (P = .018). The OTC category used most commonly was analgesics (66.3% overall), followed by vitamin and mineral supplements (38.1%), antacids (27.9%), and laxatives (9.7%). The use of analgesics decreased significantly (P = .018) with increasing age, whereas the use of laxatives increased significantly (P < .001). Women were more likely than men to be using each of these four major OTC groups. Unlike the associations with prescription drug use we reported previously in the same population, there were no significant associations for overall OTC use with age or with the use of health services. However, although vitamin use (as an example of an OTC drug taken for "preventive" purposes) was not associated with health services use, the use of laxatives (as an example of a "curative" OTC) was significantly associated (P < or = .002) with a greater number of physician visits, emergency room visits, hospitalizations during the past 6 months, home health care service utilization, and number of prescription medications.
Conclusions: A substantial proportion of our older sample reported using a variety of over-the-counter drugs. Analgesics and vitamin/mineral supplements were the most frequently used categories. Women and those with more education were taking more OTC drugs. OTC use was not related to age, but the use of analgesics decreased with age while laxative use increased with age. Unlike prescription drug use, overall OTC drug use was not associated with health services utilization.