Prescription Drug Use and Polypharmacy Rose in US Adults

A nationally representative cross-sectional study published in JAMA Network Open found that prescription drug use and polypharmacy increased among US adults from 1999 through March 2020. The proportion reporting use of at least 1 prescription drug in the previous 30 days rose from 46.7% in 1999-2000 to 56.4% in 2017-2020, while use of 5 or more prescription drugs increased from 7.8% to 16.7%.

Investigators analyzed National Health and Nutrition Examination Survey data from 58,201 adults aged 20 years or older. Medication use was identified during household interviews, with participants asked to provide medication containers or report drug names. The analysis excluded topical and other locally administered medications and used survey weighting to generate nationally representative estimates.

Increases in prescription drug use and polypharmacy were observed across age, sex, and racial and ethnic groups. The largest rise in polypharmacy occurred among adults aged 65 years or older, increasing from 21.9% to 40.7%. Among adults aged 20 to 39 years, polypharmacy remained less common but increased from 1.3% to 3.4%.

Use of several cardiometabolic drug classes increased substantially. Antihypertensive use rose from 18.3% to 30.0%, antihyperlipidemic use from 7.5% to 20.3%, and antidiabetic use from 4.6% to 11.1%. Psychotherapeutic use increased from 7.3% to 14.7%. In contrast, sex hormone use declined from 9.8% to 4.5%, and antiarrhythmic use decreased from 5.0% to 2.8%.

The investigators said the findings extend earlier NHANES analyses and indicate that long-term increases in prescription drug use and polypharmacy continued through the final survey cycle containing detailed prescription drug data. They noted that the study did not identify the factors underlying these patterns. In addition, incomplete capture of over-the-counter medications likely resulted in underestimation of overall medication use.

Source: Monroy-Iglesias MJ, Wang P, Sampathkumar Y, et al. Prescription drug use among US adults. JAMA Netw Open. 2026;9(9):e2633929. doi:10.1001/jamanetworkopen.2026.33929