Prescription Medication Data collected in the National Health and Nutrition Examination Survey NHANE

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Prescription Medication Data collected in the
National Health and Nutrition Examination Survey
(NHANES)
Ryne Paulose, Ph.D.
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Topics

• NHANES
• NHANES prescription medication data
• Data collection and editing
• Public data files and access
• Examples of data analyses

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NHANES - Objective

• To assess the health and nutritional status of
  adults and children in the United States

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NHANES

• NHES I 1960-62, ages 18-79
• NHES II 1963-65, ages 6-11
• NHES III 1966-70, ages 12-17
• NHANES I 1971-75, ages 1-74
• NHANES II 1976-80, ages 6 mos.-74
• HHANES 1982-84, ages 6 mos.-74
• NHANES III 1988-94, ages 2 mos. and older
• NHANES 1999 and beyond, all ages

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NHANES

• Sample Design
• Continuous data collection beginning in 1999
• Annual national sample of 5,000 persons
• Eligible population
• Civilian, non-institutionalized population
• Residents of all states and D.C.
• All ages

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NHANES Oversampling

• African Americans
• Mexican Americans
• Adolescents aged 12-19
• Older persons aged 60
• Pregnant women
• Low-income family

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NHANES Household Interview

• Traditional CAPI interviewing with portable
  keyboard.

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NHANES Household Interview

• Broad range of health conditions
• Environmental and occupational exposures
• Health behaviors
• Nutrition and dietary supplements
• Prescribed medications

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NHANES Mobile Exam Center
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NHANES Examination

• Standardized physical exam
• Conducted at mobile exam center
• Medical dental exams
• Physiological measurements
• Laboratory test
• Administered by trained medical personnel

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NHANES Mobile Exam Center
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NHANES TOPICS

• Cardiovascular disease
• Diabetes, lower extremity disease
• Bone status, osteoporosis
• Oral health
• Vision
• Hearing and balance
• Fitness and strength

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NHANES TOPICS, Continued

• Nutrition
• Anthropometry
• Mental health
• Risk behaviors
• Reproductive health
• Environmental exposures
• Infectious diseases

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NHANES Laboratory

• CBC and differential
• Pregnancy test
• Blood, urine and vaginal swab processing
• 76 different vials of samples
• 26 laboratories
• 300 laboratory assays

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Landmark findings and public health results

• High blood lead levels
• Lead out of gasoline
• Low folate levels
• Mandatory food fortification
• Rising levels of obesity
• Public health action plan
• Racial and ethnic disparities in Hepatitis B
• Universal vaccination of all infants children

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Prescription Medication Data
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NHANES Prescription Medications

• Collected in personal interviews
• by trained interviewers
• for all ages (gt16, self-report lt16, proxy)
• using medication inventory method

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NHANES Prescription Medications

• In the past 30 days have you used a medication
  for which a prescription was needed?
• What were they?
• May I please see the containers of all
  prescription medicines you used?
• Also record duration of use and reason for use

• In the past 30 days have you used a medication
  for which a prescription was needed?
• What were they?
• May I please see the containers of all
  prescription medicines you used?
• Also record duration of use and reason for use

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Computer Assisted Data Entry Coding
GIANT PHARMACY Store No. 1234 New Hampshire
Ave., Silver Spring, MD Rx 055 445
3456 JANE DOERx Date 01/05/02 Pharmacist NH
Qty 100.0 TAB TAKE 1 TABLET(S) TWICE A
DAY Glucophage TAB 500MG MAY
NOT REFILL
Interviewer types in exact product name from label
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Computer Assisted Data Entry Coding
A look-up window appears on the screen with
possible matches
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Post Data Collection Editing

• Convert drug names to generic ingredient name
• Prozac ? Fluoxetine Hydrochloride
• Tylenol 3 ? Acetaminophen Codeine
• Remove products incorrectly reported/recorded
• e.g., non-prescription products
• e.g., prescription dietary supplements vitamins
  
• Assign therapeutic class codes
• FDAs National Drug Code Directory
• Assign up to 6 codes per generic name
• Codes are listed in numerical order

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Prescription Medication Public Use Data File
1999

• Drug product level file
• Person with multiple drugs has multiple records
• Variables
• Respondent ID number
• Taken prescription medicine, past month (yes/no)
• Standard generic ingredient name
• Standard generic ingredient code
• FDA/NDC drug class codes 1-6
• Medicine container seen by interviewer (yes/no)
• Number of days taken medicine
• Number of Beta-agonist canisters, past month
• Number of prescription medicines taken

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Prescription Medication Data

• Currently available
• NHANES III
• NHANES 1999-2000
• Expected in first quarter of 2005
• NHANES 2001-2002

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NHANES Data
Directly download from our website http//www.cdc
.gov/nchs/nhanes.htm
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Click here to learn about the questionnaire data
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Click on hyperlinks, download self-extracting
zip files
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Uses of NHANES Prescription Medication Data

• To estimate prescription drug use in the civilian
  non-institutionalized US population
• To identify patterns of use in different
  demographic groups (e.g., race and age groups)
• Identify inappropriate use and potential adverse
  effects.

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NHANES Data
Directly download from our website http//www.cdc
.gov/nchs/nhanes.htm