Details:

Alternative Title:
BMC Public Health
Publisher's site:
http://dx.doi.org/10.1186/1471-2458-8-198
Personal Author:
Anda, Robert F ; Brown, David W ; Felitti, Vincent J ; Dube, Shanta R ; Giles, Wayne H
Anda, Robert F ; Brown, David W ; Felitti, Vincent J ; Dube, Shanta R ; Giles, Wayne H Less -
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.


Subjects:
[+]
Adult Adult Survivors Of Child Abuse Child Cohort Studies Drug Prescriptions Drug Therapy Drug Utilization Follow-Up Studies Health Maintenance Organizations Humans
Source:
BMC Public Health. 2008; 8:198.
Document Type:
Journal Article
Funding:
TS-44-10/11/TS/ATSDR CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:8c0b7a2a84f1af0bdf5fa379c8ec6f87db3f66a6f4ad295272f5b67eda72d02b
Download URL:
https://stacks.cdc.gov/view/cdc/3454/cdc_3454_DS1.pdf
File Type:

Supporting Files

• 	1471-2458-8-198.nxml	txt
  	license.txt	txt

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