{"id":641781,"date":"2026-06-16T14:48:21","date_gmt":"2026-06-16T14:48:21","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/641781\/"},"modified":"2026-06-16T14:48:21","modified_gmt":"2026-06-16T14:48:21","slug":"patterns-of-medication-use-across-society-from-national-primary-care-dispensing-data","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/641781\/","title":{"rendered":"Patterns of medication use across society from national primary care dispensing data"},"content":{"rendered":"

Between 1 November 2019 and 31 December 2024, we identified 5.8 billion prevalent medications dispensed to a population of 52.6 million individuals (Supplementary Fig. 1<\/a>). Of these dispenses, approximately 133 million were new British National Formulary (BNF) chapter initiations, reflecting the first recorded time an individual was dispensed a medication from a distinct chapter (among chapters 1\u201315). Of the study population, 53.2% were women; 27.9% were aged 60 years or older; 79.9% were of British, Irish or any other white background; and 20.7% were from quintile 1 (most deprived) of the Index of Multiple Deprivation (IMD) (Extended Data Table 1<\/a>).<\/p>\n

Incident medication dispenses over the course of the pandemic by BNF chapter<\/p>\n

After fitting Poisson models, we observed several patterns in the incident use of medications over the study period by BNF chapters (Fig. 1<\/a>). Some chapters showed a trend of ongoing decline throughout the study period, including chapters on the gastrointestinal system; central nervous system (CNS); musculoskeletal and joint diseases; skin; and obstetrics, gynaecology and urinary tract disorders. For example, the incident rate of CNS medicines in February 2024 was 4.1 per 1,000 person-months compared with 6.0 per 1,000 person-months in February 2020. Other chapters (cardiovascular system, endocrine system, nutrition and blood, anaesthesia) displayed sharp declines corresponding with the onset of the pandemic in March 2020, followed by subsequent recovery. For some chapters, including cardiovascular and endocrine, higher levels of incident dispenses were observed in the post-pandemic period (by February 2022 for CVD medications and November 2021 for endocrine medications). The remaining chapters were characterized by fluctuating peaks in dispensing, with some showing peaks before the pandemic in early 2020 (respiratory) and others exhibiting peaks in the summer of 2021, as well as from November 2022 to May 2023 (ear, nose and oropharynx; eye). Medications used to treat infections also followed this pattern, with a marked peak observed in December 2022. Immunological products and vaccines displayed particularly marked declines, with dispenses showing slow recovery and remaining much lower than pre-pandemic levels by the end of the study period.<\/p>\n

Fig. 1: Incident rates of medications dispensed, by BNF chapter (1\u201315) and sex, from November 2019 to December 2024 (per 1,000 person-months).\"Fig.The alternative text for this image may have been generated using AI.<\/p>\n

The plots show the incident rates of medications dispensed per 1,000 person-months, calculated from Poisson regression by month, BNF chapter (1\u201315) and sex, during the study period. The first three vertical lines indicate the timing of the first, second and third national lockdowns on 26 March 2020, 5 November 2020 and 6 January 2021, respectively. The fourth vertical line indicates the end of pandemic restrictions on 24 February 2022.<\/p>\n

We further examined the dispensing of incident medications over time, stratified by sex (Fig. 1<\/a>), as well as by age, deprivation and ethnic group (Extended Data Figs. 1<\/a>\u20133<\/a>). These stratifications revealed which population subgroups drove the observed trends. For example, the post-pandemic increase in the incident use of medications was most pronounced among those aged 60\u201379 years for CVD and 40\u201359 years for endocrine diseases (Extended Data Fig. 1<\/a>).<\/p>\n

Greater resolution in chapter trends was also revealed by analysis of the BNF sections and paragraphs (Extended Data Figs. 4<\/a> and 5<\/a>), highlighting the drivers of some of these trends. For example, reductions in CNS medicines were driven by decreases in the largest sections of analgesics and antidepressants. The infections chapter was dominated by antibacterials, the use of which declined and remained below pre-pandemic levels until December 2022, when a streptococcal outbreak led to increased demand for penicillin. Within other chapters, distinct and diverging trends by section and paragraph were sometimes observed. For example, within the respiratory chapter, bronchodilators, corticosteroids and antihistamines all exhibited seasonal fluctuations and variations, with pre-pandemic surges also evident for bronchodilators and corticosteroids. For obstetrics, gynaecology and urinary tract disorders, a post-pandemic decline in progesterone-only contraception was observed, whereas the use of preparations for vaginal and vulval conditions increased after the pandemic. For malignant disease and immunosuppression, pre-pandemic peaks were driven by hormone antagonists, specifically those used to treat prostate cancer.<\/p>\n

Dashboard of medicines<\/p>\n

Further examples of changes in medication dispenses at the level of BNF chemical substances during the pandemic and post-pandemic recovery period can be observed and explored through a dashboard produced as part of this project. These include the increased use of glucagon-like peptide 1 receptor agonists (GLP-1RAs), such as semaglutide, tirzepatide and liraglutide, which are indicated for type 2 diabetes and are additionally licensed for use in obesity treatment during the pandemic recovery period. Other changes involve direct-acting oral anticoagulants, as a result of NHS England commissioning policies during the pandemic9<\/a>, as well as the uptake of new-to-market medications during the pandemic (for example, bempedoic acid and inclisiran). The dashboard can be accessed at https:\/\/bhf-dsc-hds.shinyapps.io\/metrx\/<\/a>.<\/p>\n

Medication dispenses by age and intersection with sex, deprivation and ethnicity<\/p>\n

Analysis of cross-sectional data on prevalent medications in 2024, stratified by age and sex, showed how medication use was dominated by older adults, rising sharply among those in their 40s and 50s (Fig. 2<\/a>). These data reflect both age effects and cohort effects (the size of the population born in a given year and surviving until 2024, as well as migration). The marked increase in dispenses to individuals aged 77 years coincides with the post-Second World War baby boom, which is clearly evident compared with the smaller cohorts born during the war (78\u201384 years of age). Additional demographic trends and historical migration patterns were also observed (Extended Data Fig. 6<\/a>). For example, the age distribution of medicines data in Black Caribbeans showed two distinct peaks at ages 60 and 80 years, consistent with migration patterns commonly referred to as the Windrush-era migration in this ethnic group.<\/p>\n

Fig. 2: Medication dispensing in England in 2024 by BNF chapter and sex.\"Fig.The alternative text for this image may have been generated using AI.<\/p>\n

a, Count of all medications dispensed in England in 2024, categorized by BNF chapter (1\u201315) and grouped by age and sex. b, Rate of all medications dispensed per individual in England in 2024, categorized by BNF chapter (1\u201315) and grouped by age and sex.<\/p>\n

Sex<\/p>\n

In 2024, women received a higher total count of medications earlier in adult life compared with men during their 20s, 30s and 40s, particularly CNS medications (chapter 4) (Fig. 2a,b<\/a>). Sertraline, a selective serotonin reuptake inhibitor (SSRI) antidepressant, was the most common medication among men and women in their 20s and 30s; however, volumes were approximately double in women, with 4.4 million dispensations to women in their 20s and 30s in 2024 compared with 2.2 million in men (Fig. 3<\/a>). Citalopram (another SSRI antidepressant) and amitriptyline (a tricyclic antidepressant) were also among the top 10 medications dispensed to women during their 30s, 40s and 50s. In women aged 40\u201359 years, the most common medications were levothyroxine (for underactive thyroid gland), sertraline, atorvastatin (for elevated cholesterol levels) and omeprazole (for gastric acid-related disorders) (Fig. 3<\/a>). At older ages (60\u201379 years), CVD medicines, levothyroxine and proton pump inhibitors were the most frequent medications, with colecalciferol becoming increasingly important in the >80 years age group. Other sex-specific differences included the higher prevalence of medication use for obstetrics, gynaecology and urinary tract disorders (chapter 7) in women aged 20\u201339 years and in men after age 60 years (including medicines to treat, for example, erectile dysfunction and benign prostatic hyperplasia). The volume of antidepressant and CVD medication dispenses to women increased during the pandemic period (Extended Data Fig. 7<\/a>).<\/p>\n

Fig. 3: Top 10 most frequently dispensed chemical substances in England by age band and sex in 2024.\"Fig.The alternative text for this image may have been generated using AI.<\/p>\n

The bar plots show the counts of the most frequently dispensed chemical substances in England in 2024 by sex and age band (0\u20139, 10\u201319, 20\u201339, 40\u201359, 60\u201379 and 80+ years). Chemical substances are shaded according to the BNF chapter, as shown in Fig. 2<\/a>.<\/p>\n

The accumulation of CVD medications (chapter 2) from the late 40s was particularly marked in men, with 1.6 million CVD medicine dispensations to men aged 50 years and 4.3 million to men aged 60 years in 2024. This resulted in a 1.5-fold difference between sexes by age 60 years (Fig. 2a,b<\/a>), following increased dispenses during the pandemic period (Extended Data Fig. 8<\/a>). The dispensing rates of CVD medications in men were higher than in women after age 40 years, while for all other medications, rates were higher in women until later life (Fig. 2b<\/a> and Supplementary Fig. 3a<\/a>), with the exception of medications for obstetrics, gynaecology and urinary tract disorders in men from the mid-50s. By age 40\u201359 years, the three most common medications in men were all CVD drugs (atorvastatin, ramipril and amlodipine), used to treat raised cholesterol levels and hypertension (Fig. 3<\/a>). Metformin, mainly used to treat diabetes, was the fourth most common medication in men aged 40\u201359 years.<\/p>\n

Children<\/p>\n

Antibacterial medications were dominant in children, with amoxicillin being the most common medication in both sexes at ages 0\u20139 years (Figs. 2<\/a> and 3<\/a>), followed by salbutamol, which is used to treat asthma. Salbutamol was also the most common medication among children aged 10\u201319 years. During the teenage years, stimulants and medications used for attention deficit hyperactivity disorder were important for male teenagers (Extended Data Fig. 8<\/a> and Supplementary Fig. 4<\/a>), with methylphenidate being the second most commonly dispensed medication to boys aged 10\u201319 years in 2024 (Fig. 3<\/a>).<\/p>\n

Ethnicity<\/p>\n

Differences in medication use by ethnic group were also apparent (Fig. 4<\/a> and Supplementary Fig. 3b<\/a>). For most BNF chapters, the highest rates of medication use were observed in the Bangladeshi and Pakistani ethnic groups, with rate ratios (RRs) as much as 2.5 times higher by age 60 years (endocrine system, eye) (Fig. 4<\/a>) compared with the largest baseline ethnic group (British, Irish or any other white background). Children under the age of 10 years from these ethnic groups had higher RRs for some chapters (nutrition and blood, musculoskeletal, eye, skin), although absolute rates were very low except for skin (Supplementary Fig. 3b<\/a>). Pakistani children also had higher rates of dispensed medicines from the malignant disease and immunosuppression chapter. Children from several ethnic groups had RRs as high as 5 for immunological products and vaccines (including those with an African, Caribbean, Bangladeshi, Indian, Pakistani or any other Asian background). The baseline group (British, Irish or any other white background) had relatively high rates of medication dispensing for respiratory conditions and infections after age 50 years (although still lower than rates in the Bangladeshi and Pakistani groups), and the highest rates of use of CNS medications (including SSRIs and other antidepressants) during young to mid adulthood (age 20\u201350 years). Rates of use for most chapters were lowest among the Chinese ethnic group (all ages) and Indians (below 60 years of age), with the exception of immunological products and vaccines.<\/p>\n

Fig. 4: Variation in medication dispensing in England in 2024 by ethnic group.\"Fig.The alternative text for this image may have been generated using AI.<\/p>\n

Heatmaps comparing the log RR of all medication dispenses by age and BNF chapter in each ethnic group (relative to the British, Irish or any other white background baseline group).<\/p>\n

Deprivation<\/p>\n

There was evidence of higher rates of medication dispensing with greater deprivation, except for immunological products and vaccines (Fig. 5<\/a> and Supplementary Fig. 3c<\/a>). RRs were twice as high in the most deprived quintile compared with the least deprived quintile from age 40 years for the gastrointestinal, cardiovascular, CNS, nutrition and blood, and musculoskeletal chapters (Fig. 5<\/a>). In 2024, 1 million medications were dispensed to individuals aged 27 years in the most deprived IMD quintile, whereas this number of dispenses was not reached in the least deprived quintile until age 42 years (Supplementary Fig. 5<\/a>). One of the most marked differences according to the IMD was the much higher and earlier use of medications from the CNS chapter, dominated by treatments for mental health conditions and pain (antidepressants, analgesics), which showed an acceleration from the mid-20s in more deprived IMD groups (Fig. 5<\/a> and Supplementary Fig. 5<\/a>). There was also a higher count of medication dispenses to children in the most deprived quintile, with RRs above 2 observed for nutrition and blood, musculoskeletal, and immunological products and vaccines in children aged 5 years (Fig. 5<\/a>).<\/p>\n

Fig. 5: Variation in medication dispensing in England in 2024 by deprivation.\"Fig.The alternative text for this image may have been generated using AI.<\/p>\n

Heatmaps comparing the log RR of all medication dispenses by age and BNF chapter in each IMD quintile (relative to the least deprived group, IMD\u2009=\u20095).<\/p>\n

Polypharmacy<\/p>\n

The dominant trend in the population was receiving no medication or only one medication until the age of 64 years (Fig. 6a<\/a>). However, the proportion of the population with polypharmacy increased steadily with age: by age 50 years, approximately 15% of the population had been dispensed five or more medications within a 3-month period, increasing to 42% by age 70 years (Extended Data Table 2<\/a>). At 70 years of age, approximately 12% were dispensed ten or more medications within a 3-month period. While the level of polypharmacy was low among children, 5% of 3-year-olds were dispensed three or more medications within a 3-month period, and 1% were dispensed five or more medications within the same timeframe. Stratifying by IMD quintiles showed a clear differential, with half of the population in the most deprived quintile dispensed five or more medications in their late 60s\u2014a level not reached until the late 70s in the least deprived quintile (Supplementary Fig. 6<\/a>). Similarly, differences by ethnic group were observed, with Bangladeshi and Pakistani people having higher levels of polypharmacy earlier in life (Supplementary Fig. 7<\/a>).<\/p>\n

Fig. 6: Trends in polypharmacy in England by age and time.\"Fig.The alternative text for this image may have been generated using AI.<\/p>\n

a, Proportion of the population dispensed multiple medications within the 3-month period ending in December 2024, by age. b, Proportion of the population dispensed multiple medications, from November 2019 to December 2024. The first three vertical lines indicate the timing of the first, second and third national lockdowns on 26 March 2020, 5 November 2020 and 6 January 2021, respectively. The fourth vertical line indicates the end of pandemic restrictions on 24 February 2022.<\/p>\n

Polypharmacy increased gradually over the course of the study period (Fig. 6b<\/a>). By December 2024, approximately 14.6% of the population had been dispensed five or more medications within a 3-month period.<\/p>\n","protected":false},"excerpt":{"rendered":"Between 1 November 2019 and 31 December 2024, we identified 5.8 billion prevalent medications dispensed to a population…\n","protected":false},"author":2,"featured_media":641782,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42],"tags":[113834,5589,3250,102,157624,81848,157623,90812,6591,3249,56,54,55],"class_list":["post-641781","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-drug-delivery","tag-epidemiology","tag-general","tag-health","tag-health-economics","tag-health-promotion-and-disease-prevention","tag-health-psychology","tag-maternal-and-child-health","tag-medication","tag-medicine-public-health","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/641781","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=641781"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/641781\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/641782"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=641781"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=641781"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=641781"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}