From Vital and Health Statistics of the National Center for Health Statistics Number 89 � April 15, 1983 

PROPERW OF THE 

PU5L!CATIONS M3ANCH 

EDITORIAL LIBRARY 

Drugs Most Frequently Used in Office Practice 

National Ambulatory Medical Care Survey, 1981 

e 

# 

by Hugo Koch, Division 

This report offers descriptive data about the drugs 

utilized in office practice in the calendar year 1981, 

highlighting those pharmaceutical agents that were most 

frequently ordered or provided. The data, based on the 

findings of the National Ambulatory Medical Care Survey (NAMCS), were produced by a representative samIe of the Nation’s physicians who are primarily engaged 

1ofllce-based, patient-care practice. Non-Federal doctors of medicine and osteopathy in all states except 

Alaska and Hawaii participated by completing records 

(figure 1, Patient Record) on a sample of their office 

visits over a weekly reporting period. 

Item 11 of the Patient Record (figure 1) requires that 

the respondents report the names of the specific drugs 

that they “utilized” (that is, ordered or provided) in the 

course of their office visits. This resulted in an estimated 

651,153,000 drug mentions. All routes of administration 

were allowed, and the mentions included immunizing 

and desensitizing agents, and nonprescription as well as 

prescription drugs. The physician recorded all new drugs 

and continued medications when the patient was specifically instructed during the visit to continue the medication. Drugs ordered through telephone contact were not 

included. 

Because the estimates presented here are based on a 

sample rather than on the entire universe of office visits, 

the data are subject to sampling variability. Because of 

problems with statistical significance, the data user 

should avoid too literal an acceptance of closely ranked 

estimates. The technical notes at the end of this report 

provide a brief explanation of the sampling errors and 

idelines for judging the precision of estimates. All 

ubsequent references to drug mentions should be interpreted as estimated drug mentions, based on the sample 

of office-based physicians used in this study. 

of Health Care Statistics 

The 100 drug entries that respondents most frequently 

recorded are listed in rank order in table 1. The listing is 

arbitrarily restricted to the drugs that were specifically 

named—either by brandl or by generic name. This led 

to the exclusion of two entry choices that did not identify 

a specific agen~ indicating only the therapeutic effect 

desired. These two therapeutic effects were 

�	 Allergy relief ordzots( unspecified), with 10,833,000 

mentions. 

� Vihmru%(s)(unspecified), with 1,520,000 mentions. 

The 100 drugs comprise only 4 percent of the 2,325 

agents named by respondents. However, they account 

for about 341,427,000 mentions, or 52 percent of the 

total 651,153,000 drug mentions. 

The 11 drugs most frequently named in 1981 were 

also the leading 11 in 1980. The rank order of the 

specific drugs, however, varied somewhat between the 

years (table 2). The two most notable gains in rank 

position were registered by Inderal, a beta-adrenergic 

blocking agent, and Dyazide, a diuretic agent. 

In table 3, drug utilization in 1981 is expressed 

entirely in generic terms. Listed in alphabetical order 

are the 100 generic substances most frequeiitly ordered 

or provided, either in single-entity form or as ingredients 

of combination products. Thus, the 29,687,000 total 

mentions of the ranking generic substance, hydrochlor~ 

thiazide, include its 11,583,000 mentions as a singleentity drug and its 18,105,000 mentions as an active 

component of a combination drug. 

1Inclu5ionoftiade names isfor identification only and does not imply endorsement by the Public Health Service or the U.S. Department of Health and 

Human Services. 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 
2 .-. — ... —-

ASSURANCE OF CDNFM3ENTAL1TY-AII ,nlo, ret,.. ~h,m tw,.ld n,,m,t ,d,. t,l,ret,.. Deca,tm.?n,01 Hml,h, Ed.,, !,.., ..<{ W’.ll.,,, 

01 ,“ md!v,dual. . w.”,cE.. ., ,“ ,S.bl,,hmmt w,I, be held Co”l,d,”,,,l, wI! b, .sed .“!” Puhl,cHal, h S.,.,­

t-i oerso.s ..*@ m and 10. me P.um5es 0! the w-v and .mm m be d,scbmd m w 011,,. .1 Hml,h Remr,h. S,,,,,,,C5, ,“<( T,.Ch,,<,!”<~” cNO.qg$jgsz 

Iw,fd 10otherPm-, a used10T..” mhezOU,POS Nm,.amlCent.<for Heal,h S,,,, S,,., 

1- DATE OF VISIT PATlENT RECORD + NATIONAL AMBULATORY MEDICAL CARE SURVEY 

ZmDATE OF 3. SEX 4= COLOR OR RACE 5, ETHNICITY & PATI ENT’S COMPLAINT(S), SYMPTOM(S), OR OTHER 

S1RTH 

1 � WH,TE 

REASON(S) FOR ~ VISIT /In paricnrk own words/ 

2 � BL4CK 1 � H&PA#C ,, MOST IMPORTANT 

#-z- ::n 3 q~amm 2 � NOT 

m, Ymr HISPANIC b, OTHER 

4 l_JAMERIcANINDiAN/ 

ALASKAN NATIVE 

7. MAJOR liEASON FOR THIS a- DIAGNOSTIC SERVICES THIS VISIT ~. PHYSICIANS DIAGNOSES 

VISIT fCheck onel 

I � ACuTE PROBLEM 

2 � cHRoNIC PROBLEM. ROUTINE 

3 � CH*ONICPR08LEM. FWRE.P 

4 � POSTS.RGERYIPOm,WURY 

5 � NON.ILLNESmRE(ROUT,NE 

PRENATAL. GENERAL EXAM.. 

WELL BABY. ETC.) 

10- HAVE YOU SEEN 

PATlENT BEFORE? 

,DYES ,ONO 

J 

IF YES. FOR THE 

CONDITION IN 

ITEM%> 

, � YES 2 � NO 

{Check .1[ ordefed or providedJ 

I � NONE , � EKG e PRINCIPAL OIAGNOSIS/PROBLEM ASSOCIATE WITH ITEM 6.3 

2 � LIMITED HISTORY,EXAM. 9 � VISION TEST. 

3 � GEt4ERA’ H12TORV,EXAM. I. � ENDOSCOPY 

~ � pAp TEsT 11 � MENTAL STATUS 

EXAM. b OTHER SIGNIFICANT CURRENT DIAGNOSES 

5 � CLINICAL LAB TEST 

~ � xRAy ,2 � OTHEFr(Sp.CJJt, 

7 j_J8L0013pRESsuRE cHECK 

11. MEDICATION THERAPY THIS VISIT � NONE 

f Usinx bmnd or Xeneric names. record all new und con tinut-d tnedicarions ordered, injected. udminisrert’d, w otl?erwise 

provided at this vim. Include immunizing and desensitize in,qagen ts/ 

d. FOR PRINCIPAL OIAGNOSES IN ITEM 93. 

1. 

2. 

3. 

4. 

12- NON-MEDICATION THERAPY 13. WAS PATlENT 14 

[Check all services ordered or provided this visir/ REFERRED 

I � NONE 

2nP”YS,ClT”ERAFW 

3 � OFFICE SURGERY 

4DFAMILYF’IANN,NG 

5 � PSYCHOTHEFIAPV/ 

THERAPEuTIC LISTENING 

PHS-61 OS-C [9/79) 

FOR THIS VISIT 

BY A~HE R 

6 � DIET COUNSELING PHYSICIAN? 

7nFAMILY/sOcIAL 

COUNSELING 

8 � MEIXALCO.NSEIJNG , HYES 

9j_J0THER (SWCJJ,.J 

,Dluo 

Figure 1. Patient Record 

b. FOR ALL OTHER REASONS 

1 

2 

3, 

( 

4. 

DISPOSITION THIS VISIT 15. OURATION 

“ [Check ail that UPPi,V/ OF THIS 

1 � NO FOLLOW.UP PLANNEO	

VISIT 

I Time actwi[r 

2 � RETLIRNATSPECIFIEO TiME	 spefl t wirll 

ph,v,Y(cion/ 

3 � RETufl N IF NEEOED, P.R. N. 

. � TELEpHO NE FOLLOW.UP PLANNEO 

5 � REFERflE0T007HER PHYSICIAN 

6 � RETURNED TO REFERRING PHYSICIAN 

7 l_JADMITTO HOSPITAL 

8 � OTHER ,s,<<,,,) 

M,””!,,, 

OMB No. 68-R1498 

Another usefil overview of 1981 drug utilization 

appears in table 4. Here the651, 153,000 ~g mentions 

are described by the chief therapeutic effect that each 

was intended to produce. A comprehensive listing of 67 

therapeutic categories is used. (The categories were 

selected from the American Hospital Formulary Classtication System.z) The data user may note the obvious 

preeminence enjoyed by the nontropical anti-infective 

agents, the central nervous system drugs, and the combination of cardiovascular drugs and diuretics used to 

2American Society of Hospital Pharmacists, Inc.: The ,Onericszn Hospital 

Formulary Classt#ication System Washington. Jan. 1980. 

combat circulatory disease. Together these three categories accounted for virtually one:half of all drug mentions. 

From 1980 to 1981, the use proportion (percent of 

all drug mentions) did not vary greatly for most of the 

therapeutic categories (table 5). The largest single decrease (0.6 percent) was registered by skin preparations. 

Their estimated number of mentions fell by about 6.2 

million in 1981. These findings directly parallel a 0.6 

percent drop found in 1981 for the number of office 

visits with skin disease as the principal diagnosis. Th 

largest single increase in use proportion ( 1.8 percentu 

was achieved by the combination of cardiovascular 

drugs and diuretics. Their estimated number of mentions rose by about 6.7 million in 1981. This increase 
admce&a3 

w“ 

appears directly related to the 0.7-percent increase found 

in 1981 for the number of ofilce visits with circulatory 

isease as the principal diagnosis. Also contributing to 

e increase was the sharp surge in popularity enjoyed 

by certain new cardiovascular drugs, especially the 

beta-adrenergic blocking agents. They are useful in 

treating hypertension, angina, cardiac arrhythmia, and 

in preventing the recurrence of myocardial infarction. 

Measured in terms of drug-visit proportion (that is, 

the percent of office visits at which one or more drugs 

were ordered or provided), the overall utilization of 

drugs by office-based physicians fell from 63.1 percent 

in 1980 to 60.5 percent in 1981, a decrease of 2.6 

percent. 

NAMCS drug findings for 1981 are reportable by 

product name, generic name, entry status (generic versus brand name), prescription status (prescription versus 

nonprescription), level of potential abuse (Federal control schedules), composition (single-ingredient versus


combination), and therapeutic effect. These drug dimen­


sions may be contrasted with other NAMCS variables


to show the influence on drug utilization produced by


prescriber characteristics, patient demographics, refer­


ral status, duration and disposition of the visit and by


such clinical features as symptoms, diagnosis, diagnos­


tic procedures, and other (nondrug) forms of treatment.


Inquiries about the NAMCS drug database may be


directed to


Hugo Koch


National Center for Health Statistics


Center Building 2, Room 2-43


3700 East-West Highway


Hyattsville, Md 20782


Telephone (301)436–71 32

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

4 adwlncedata 

Tablel. The 100 drugs most frequently ordered or provided in office practice by drug name (as recorded by the physician), number of mentions, and therapeutic use: 

United States, 1981 

Number R 

a 

n 

k 

48 

49 

50 

51 

52 

53 

54 

55 

56 

57 

58 

59 

60 

61 

62 

63 

64 

65 

66 

Name of drug 

All drugs,.,.,....,...,...,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Inderal (propranolol) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Lasix(furosemide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Dyazide (triamterene, hydrochlorothiazide. . . . . . . . . . . . . . . . ., ., . . . . 

Ampicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Penicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Aspirin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Lanoxin (digoxin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tetracycline, .,........,...,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diphtheria tetanus toxoids pertussia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Polio vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Valium (diazepam) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Motrin (ibuprofen) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Amoxicillin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Etythromycin .,........,...,., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Prednisone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

E. E. S.(erythromycin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,., .,.,. 

Aldomet (methyldopa) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tagamet (cimetidine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hydrochlorothiazide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Dioxin, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hydrodiuril (hydrochlorothiazide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Amoxil(amoxicillin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hygroton [chlorthalidone) ..,....,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Keflex(cephalexin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Oimetapp (brompheniremine, phenylephrine, phenylpropanolamine) . . . . . . . . . . . . 

Tylenol with codeine (acetaminophen, codeine). . . . . . . . . . . . . . . . . . . . . ., ., ., . 

Actifed (triprolidine, pseudoephedrine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Isordil (isosorbide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Vitamin 8-12......,............,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Naprosyn (naproxen), . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Septra(sulfamethoxazole, trimethoprim) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tuberculin tine test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

8actrim (sulfamethoxazole, trimethoprim) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Clinoril (sulindac) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tylenol (acetaminophen) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Lopresaor (metoprolol) ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Phenergan (promethazine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Indocin (indomethacin) ...,.,... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

8enad@(diphenhydramine) .,... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Decadron (dexamethasone) ..,... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nitroglycerin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Slow- K(potassium replacement solutions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Zomax(zolamine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diabinese (chlorpropamide) .,... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Pen-Vee K (penicillin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Premarin (estrogens) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Depo-medrol (methylprednisolone). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Kenalog (triamcinolone) . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Donnatal (hyosciamine, atropine, hyoscine, phenobarbital) . . . . . . . . . . . . . . . . 

Influenza virus vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Coumadin (warfarin). .,........,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Ceclor(cefaclor) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Neosporin (polymixin-B, neomycin).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Synthroid (levothyroxine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Dimetane (brompheniramine) .,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

E-mycin (erythromycin) ..,.,.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Aldoril (methyldopa, hydrochlorothiazide) . . ., ., ., . . . . . . . . . . . . . . . . . . . . . . . 

Bicillin (penicillin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Xylocaine (lidocaine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

8utazolidin [phenylbutazone) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Naldecon (phenylephrine, phenylpropanolamine, chlorpheniramine) . . . . . 

Darvocet-N (propoxyphene, acetaminophen), . . . . . . . . . . . . . . . . . . . . ., . . . 

Mylanta (magnesium hydroxide, aluminum hydroxide) . . . ., . . . . . 

Antivett (meclizine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Elavil(amitripty line) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

of 

mentions 

in 

thousands 

651,153 

11,847 

10,770 

10,422 

9,173 

8,581 

7,543 

7,311 

7,030 

6,583 

6,237 

6,063 

5,967 

5,877 

5,606 

5,575 

5,535 

5,418 

5,375 

6,326 

5,285 

5,086 

5,020 

4,349 

4,314 

4,195 

4,141 

4,085 

3,892 

3,782 

3,758 

3,575 

3,476 

3,397 

3,337 

3,277 

3,271 

3,270 

3,258 

3,106 

3,096 

2,999 

2,988 

2,904 

2,872 

2,871 

2,854 

2,801 

2,670 

2,607 

2,589 

2,556 

2,386 

2,317 

2,278 

2,269 

2,253 

2,252 

2,241 

2,238 

2,231 

2,229 

2,182 

2,156 

2,077 

2,063 

2,055 

Therapeutic use 

Arrhythmia, angina pectoris, hypertension, migraine


Diuretic, antihypertensive


Diuretic, edema, hypertension


Antibiotic


Antibiotic


Analgesic, antipyretic


Cardiotonic


Antibiotic


Immunization


Immunization


Anxiety disorders


Anti-inflammatory, analgesic


Antibiotic


Antibiotic


Anti-inflammatory


Antibiotic


Antihypertensive


Ulcer and gastrointestinal disease


Diuretic


Antidiabetic


Cardiotonic


Diuretic


Antibiotic


Diuretic, antihypartensive


Antibiotic


Antihistaminic, decongestant


Analgesic


Common cold, allergic rhinitis


Coronary vasodilator


Vitamins


Anti-inflammatory, analgesic, antipyretic


Urinary infections, otitis media, pneumonitis


Tuberculosis skin test


Urinary infections, otitis media, pneumonitis


Analgesic, anti-inflammatory


Analgesic


Antihypertensive, beta-blocker


Expectorant


Anti-inflammatory


Antihistaminic


Anti-inflammatory


Vasodilator


Potassium replacement therapy


Analgesic


Hypoglycemic agent


Antibiotic


Estrogen replacement therapy


Glucocorticoid


Anti-inflammatory


Sedative, antispasmodic


Immunization


Anticoagulant


Antibiotic


Bacterial infections, topical


Thyroid hormone


Expectorant


Antibiotic


Antihypertenaive


Antibiotic


Local anesthetic


Anti-inflammatory


Hay fever, sinus, congestion


Analgesic


Antacid, antiflatulent


Antinauseant


Antidepressant

adwlncedata 5 

Table 1. The 100 drugs most frequently ordered or provided in office practice by drug name (as recorded by the physician), number of mentions, and therapeutic use 

United States. 1981 —Con, 

Number R

* of a Name of drug mentions Therapeutic use n in k thousands 

� 

67 Dilantin (phenytoin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,054 Anticonvulsant 

68 Empirin with codeine (aspirin, codeine). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,042 Analgesic, antipyretic 

69 Dalmane (flurazepam) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,041 Hypnotic 

70 Cleocin (clindamycin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,033 Antibiotic 

71 Potassium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,028 Potassium replacement therapy 

72 Theo-dur(theophy nine). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,026 Coronary vasodilator, diuretic 

73 Cortisporin (polymixin-B, bacitracin, neomycin, hydrocortisone) . . . . . . . . . . . . . . . . 1,979 Anti-inflammatory 

74 Phenergan with codeine (promethazine, codeine) . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,97B Expectorant 

75 Vibramycin (doxycycline) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,957 Antibiotic 

76 V-cillin (penicillin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,946 Antibiotic 

77 Persantine (dipyridamole) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,932 Coronay or myocardial insufficiency 

78 Rondec (pseudoephedrine, carbinoxamine maleate). . . . . . . . . . . . . . . . . . . . . . . . . . 1,928 Decongestant, antitussive 

79 T[moptic (timolol) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,914 Treatment of glaucoma, ocular hypertension 

80 Prenatal vitamins (multivitamins prenatal). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,873 Vitamins 

81 Minipress (prazosin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,789 Antihypertensive 

82 Aldactazide (spironolactone, hydrochlorothiazide) . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,788 Antihypertensive 

83 Aristocort (triamcinolone) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,766 Anti-inflammatory 

84 Monistat [miconazole) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,743 Antifungal 

85 Phenobarbital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,694 Anticonvulsant, sedative, hypnotic 

86 llosone (e~thromycin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,692 Antibiotic 

87 Larotid (amoxicillin) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,640 Antibiotic 

88 Librax (clidinium bromide, chlordiazepoxide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,635 Gastro-intestinal disorders 

89 Robitussin (guaifenesin, dextromethorphan, phenylpropanolamine) . . . . . . . . . . . . . 1,633 Antitussive, decongestant, expectorant 

90 Sudafed (pseudoephedrine) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,604 Decongestant 

91 Tuss-ornade (chlorpheniramine, phenylpropanolamine). . . . . . . . . . . . . . . . . . . . . . 1,580 Antitussive, decongestant 

92 Ativan(lorazepam) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,579 Psychotherapeutic agent 

93 Librium (chlordiazepoxide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,569 Psychotherapeutic agent 

94 Flexeril (cyclobenzaprine] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,568 Skeletal muscle relaxant 

95 Zylopnm (allopunnol} . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,567 Antigout 

96 Dnxoral (bromphenwamme, pseudoephedrine) . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,561 Decongestant, antihistamine 

97 Corgard (nadolol] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.550 Antihypertensive, beta-blocker 

98 Celestone (betamethasone) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,544 G[ucocorticoid 

99 Parafon forte (chlorzokazone, acetammophen) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,528 Skeletal muscle relaxant 

100 Ortho-novum (norethmdrone, estradiol). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,519 Oral contraceptive 

Table 2. The 11 drugs most frequently named in 1980 and 1981 by frequency of mention and rank ordec United States, 1981 

Number of 

mentions Rank 

Name of drug in thousands 

1987 1980 1981 1980 

11,847 9,625 1 4 

10,770 9,879 2 1 

10,422 7,435 3 7 

9,173 9,795 4 2 

8,581 9,736 5 3 

7,543 8,800 6 6 

7,311 7,105 7 8 

7,030 9,478 8 5 

6,583 6,067 9 11 

6,237 6,535 0 9 

Valium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,063 6,499 11 10 
6 acklncechta 

Table 3. Number of drug mentions, rank, and therapeutic use of the 100 generic aubstancea most frequently utilized in office practice United States,”1 981 

Number R of a Genen”c substance mentions n in k thousandsl 

10,830 14 

4,092 59 

2,193 97 

4,670 53 

2,137 98 

4,674 52 

12,356 11 

10,270 17 

17,268 3 

5,871 38 

5,265 47 

3,343 73 

3,509 70 

3,393 72 

8,165 20 

6,111 33 

2,317 96 

4,195 56 

4,018 60 

12,789 9 

2,676 87 

5,494 42 

5,696 47 

7,433 23 

5,438 43 

3,246 78 

6,165 32 

12,397 10 

4,163 57 

6,583 29 

2,782 90 

17,468 2 

5,755 39 

2,883 86 

10,861 13 

8,222 18 

3,903 62 

29,687 1 

6,670 26 

3,140 80 

5,401 44 

5,984 35 

3,199 79 

2,912 85 

5,314 46 

3,849 64 

5,975 36 

3,995 61 

4,842 51 

2,588 94 

2,956 83 

5,122 49 

3,321 74 

7,757 21 

3,579 67 

3,270 76 

11,951 12 

4,127 58 

8,216 19 

5,077 50 

3,014 82 

2,599 93 

2,757 91 

17,035 4 

5,384 45 

2,083 100 

Therapeutic use w 

Analgesic, antipyretic 

Analgesic, antipyretic


Antigout


Antacid


Astringent waah


Antidepressant


Antibiotic


Antibiotic


Analgesic, antipyretic


Anticholinergic


Antibiotic 

Keratolytic, acne treatment 

Glucocorticoid 

Antidiarrhea 

Expectorant 

Stimulant 

Antibiotic 

Antibiotic 

Emotional disturbance, aedative 

Antihistaminic 

Hypoglycemic agent 

Diuretic, antihypertensive 

Ulcer and gastrointestinal disease 

Analgesic, antitussive 

Anti-inflammatory 

Cough suppressant 

Sedative, tranquilizer 

Cardiotonic 

Antihistaminic 

Immunization 

Antibiotic 

Antibiotic 

Estrogen replacement therapy 

Estrogen replacement therapy 

Diuretic 

Cough suppressant 

Antihypertensive 

Diuretic


Anti-inflammatory


Sedative, tranquilizer


Anticholinergic


Anti-inflammatory


Anti-inflammatory


Immunization


Antidiabetic


Emetic


Iron deficiency


Anticholinergic


Coronary vasodilator


Thyroid hormone


Local anesthetic


Antacid


Antinauaeant


Antihypertensive


Glucocorticoid 

Beta-adrenergic blocker 

Vitamins 

Anti-inflammatory, analgesic, antipyretic 

Antibiotic 

Vasodilator 

Oral contraceptive 

Antifungal 

Narcotic analgesic 

Antibiotic 

Antipyretic, analgesic 

Antihistaminic 
dwlceMa7 

Table3. Number ofdrugmentions, rank, andtherapeutic useofthe 100generic substances most frequently utilized inoffice practice United States,1981 -Con. 

Number R of a 

Generic substance mentions Thempeutic use 

Q in n 

k thousands~ 

� 

Phenobarbital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,011 34 Anticonvulsant, sedative, hypnotic 

Phenylbutazone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,742 92 Anti-inflammatory 

Phenylephrine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,140 6 Sympathomimetic 

Phenylpropanolamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,455 5 Sympathomimetic 

Phenyltoloxamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,037 81 Antihistaminic 

Polio vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,248 31 Immunization 

Polymixin B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,259 30 Antibacterial 

Potassium guaiacolsulfonate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,868 63 Cough preparations 

Potassium replacement solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,665 22 Potassium replacement therapy 

Prednisolone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,778 66 Anti-inflammatory 

Prednisone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,706 40 Anti-inflammatory 

Promethazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,939 37 Antihistaminic, anti-emetic, sedative 

Propoxyphene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,551 68 Analgesic 

Propranolol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,813 8 Beta-blocker 

Pseudoephedrine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,933 7 Antihistaminic, cough suppressant 

Reserpine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,204 55 Antihypertensive 

Salicylic acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,126 99 Antifungal, keratolytic 

Scopolamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,528 69 Hypnotic, sedative, anticholinergic 

Simethicone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,. 2,926 84 Antiflatulent 

Spironolactone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,826 89 Diuretic 

Sulfacetamide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,258 77 Antibacterial 

Sulfamethoxazole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,393 24 Antibacterial 

Sulindac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,318 75 Analgesic, antipyretic 

Tetracycline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,316 16 Antibiotic 

Theophylline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,647 27 Coronary vasodilator, diuretic 

Triamcinolone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,616 28 Anti-inflammatory 

Triamterene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,681 15 Diuretic 

Trimethoprim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,150 25 Antibacterial 

Triprolidine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,647 54 Antihistaminic 

Tuberculin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.423 71 Tuberculosis skin test 

Vitamin B-12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 5,137 48 Vitamins 

Warfarin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,536 95 Anticoagulant 

Zinc topical agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,805 65 Skin disease (astringent, antiseptic) 

Zolamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,872 88 Antihistaminic, local anesthetic 

lc~~binesthemention$of agenericsubstsnce as asmgle-ingredient agent wnthits mentnons as an mgred!entof a combination dreg. 
8 admncedata 

Table4. Number andpercent distribution ofdrugmentions byselected therapeutic categories United States, l98l 

Number Number 

of Percent of Percent 

Selected therapeutic categories mentions distri- Selected therapeutic categories mentions distri- 0 

in bution in bution 

thousands thousands 

All categories..............,., . . . . . . . . . . . 651,153 100.0 Eye, ear, noae, andthroat preparations—Con. 

Anti-inflammatory agents. . . . . . . . . . . . . . . . . . 4,772 0.73 

Antihistami ne drugs . . . . . . . . . . . . . . . . . . . 43,511 6,68 Local anesthetica . . . . . . . . . . . . . . . 1,947 0.30 

Anti-infective agents . . . . . . . . . . . . 104,804 16.10 Miotics . . . . . . . . . . . . . . . . . . . . . . . . 1,590 0.24 

Anti biotics . . . . . . . . . . . . . . . . . . 89,209 13.70 Mydriatics . . . . . . . . . . . . . . . . . . . . . . . 1,666 0.26 

Cephalosporins . . . . . . . . . . . . . . . . 8,355 1.28 Vaaoconstrictora . . . . . . . . . . . . . . . . . 2,004 0.31 

Erythromycins . . . . . . . . . . . . . . . . . 16,119 2.48 Gastrointestinal drugs . . . . . . . . . . . . . . . . . . . . . 24,196 3.72 

Penicillins . . . . . . . . . . . . . . . . . . . . . . . 41,524 6.38 Antacids andadsorbents . . . . . . . . . . . . . . . . . . 3,562 0.55 

Tetracycline . . . . . . . . . . . . . . . . . . 15,010 2.31 Antidiarrhea agents. . . . . . . . . . . . . . . 3,324 0.51 

Sulfonamides . . . . . . . . . . . . . . . . . . . . . . 9,236 1.42 Antiflatulenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,947 0.45 

Antineoplastic agents . . . . . . . . . . . 4,019 0.62 Cathartica and laxatives . . . . . . . . . . . . . . . . . . . 3,655 0.56 

Autonomic drugs . . . . . . . . . . . . . . . 24,102 3,7’0 Emetics and anti- emetics . . . . . . . . . . . . . . . 3,776 0.58 

Paraaympatholytic agents . . . . . . . . . . . . . . . . 9,574 1.47 Hormones and synthetic substances. . . . . . . . . . 53,999 8.29 

Skeletal muscle relaxants . . . . . . . . . . . . . . . . 5,737 0.88 Adrenals . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,731 3.18 

Sympathomimetic agenta. 7,235 1.11 Contraceptives . . . . . . . . . . . . . . . . . 6,141 0.94 

Blood formation and coagulation. . 8,020 1.23 Estrogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,877 1,06 

Anti-anemia druga . . . . . . . . . . . . . . 5,325 0.82 Insulina andantidiabetic agents . . . . . . . . . . . . 10,901 1.67 

Anticoagulants . . . . . . . . . . . . . . . . . . . 2,675 0.41 Insulins . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,314 0.82 

Cardiovascular drugs, ., .,.,...., . . . . . . . . . . 68,779 0.56 Thyroid and antithyroid . . . . . . . . . . . . . . . . . 4,328 0.66 

Cardiac druga . . . . . . . . . . . . . . . . . . . . . . . . . . 30,184 4.64 Serums, toxoids, and vaccines. . . . . . . . . . . . . . . . . . 22,068 3.39 

Hypotenaive agents, .,....... 24,263 3.73 Toxoids, . . . . . . . . . . . . . . . . . . . . . . . . . . 8,813 1.35 

Vasodilating agents, . . . . . . . . . . . 13,730 2.11 Vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,655 1.94 

Central nervoua aystem drugs, . . . . . . . . . . . 104,391 6.03 Skin andmucous membrane preparations . . . . . . . 49,026 7.53 

Analgesics and antipyretics. ., . . . . . . . . 58,841 9,04 Anti-i nfectives . . . . . . . . . . . . . . . . . . . . . . . . . 12,049 1.85 

Anticonvulsants . . . . . . . . . . . . . . . . 2,858 0.44 Fungicides . . . . . . . . . . . . . . . . . . . . . . . 4,781 0.73 

Antidepressants . . . . . . . . . . . . . . . . . . 9,892 1,52 Anti-i nflammatory agenta. . . . . . . . . . . . . . . . . . 17,463 2.68 

Respiratory andcerebral stimulants 4,501 0,69 Antipruritics and local anesthetics . . . . . . . . . 4,506 0.69 

Tranquilizers, sedatives, and hypnotics . . . . . 27,574 4,23 Emollients, protestants, demtdcents . . . . . . . . . 2,989 0.46 

Electrolytic, caloric, and water balance 

Diuretics . . . . . . . . . . . . . . . . . . . 

Replacement solutions . .,.,,,.,. 

. . . 55,277 

45,239 

8,527 

8.49 

6.95 

1,31 

Keratolytic agents . . . . . . . . . . 

Spasmolytic agents . . . . . . . . . .. . . . 

Vitamins . . . . . . . . . . . . . . . . . . . . . . 

. 

. 

. 

. 

. 

. . 

. . 

. . 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

5,860 

10,654 

20,507 

0.90 

1.64 

3.15 � 

Expectorants and cough preparationa. 17,864 2,74 Multivitamin preparations. . . . . . . . . . . . . . . . . . 11,638 1.79 

Eye, ear, nose, andthroat preparationa. . . 23,546 3,62 Vitamin 8 complex . . . . . . . . . . . . . . . . . . . . . . . 5,939 0.91 

Anti-infective agenda, . . . . . . . . . . . . . . . . . . 6,330 0.97 Other agents or therapeutic categow 

Antibiotics . . . . . . . . . . . . . . . . . . . . . . . 3,830 0.59 undetermined . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,393 2.52 

18aSedo" the PharmaCOlOgiC.ther~ peuticclsssificatio" of the American SOCietyOf H0Spi<al Pharmacists, inc.; selected categories reproduced tvithpermissi0n. 
aciuamx!data 9 

Table 5. UsepropoRion ofselected therapeutic categories ofdrugs utilized inofice practice in1980and 1981: United States, 1981 

Selected therapeutic catego# 

0 

All categories . . . . . . . . . . . . . . . . . . . . . 

All categories . . . . . . . . . . . . . . . . . . . . . 

Adrenals . . . . . . . . . . . . . . . . . . . . . . 

Analgesia and antipyretics . . . . . . . . . . 

Antidepressants . . . . . . . . . . . . . . . . . . . 

Antihistamine drugs . . . . . . . . . . . . . . . . 

Anti-infective agents. . . . . . . . . . . . . . . . 

Antineoplastic agents. . . . . . . . . . . . . . . 

Autonomic drugs . . . . . . . . . . . . . . . . . . . 

Blood formation and coagulation. . . . . . 

Cardiovascular drugs and diuretics . . . . 

Use proportion 

198? 7980 

Number of mentions in thousands 

651,153 679,593 

Percent distribution 

100.0 100.0 

3.2 2.7 

9.0 8.5 

1.5 1.5 

6.7 6.5 

16.1 15.4 

0.6 0.8 

3.7 3.7 

1.2 1.2 

17.6 15.8 

Use proportion 

Selected therapeutic categoryl 

1981 1980 

Contraceptives . . . . . . . . . . . . . . . . . . . . 

Expectorants and cough 

preparations . . . . . . . . . . . . . . . . . . . . 

Eye, ear, nose, and throat 

preparations . . . . . . . . . . . . . . . . . . . 

Gastrointestinal drugs . . . . . . . . . . . . . . 

Serums, toxoids, and vaccines. . . . . . . . 

Skin and mucous membrane 

preparations . . . . . . . . . . . . . . . . . . . . 

Spasmolytic agents . . . . . . . . . . . . . . . . . 

Tranquilizers, sedatives, hypnotics . . . . 

Vitamins . . . . . . . . . . . . . . . . . . . . . . . . . 

Other agents or therapeutic catego~ 

undetermined . . . . . . . . . . . . . . . . . . . 

Percent distribution 

0.9 1.2 

2.7 2.8 

3.6 3.8 

3.7 3.6 

3.4 3.5 

7.5 8.1 

1.6 1.7 

4.2 4.4 

3.2 3.6 

9.5 11.2 

1Basedon the pharmacologic-therapeuticclassification of the American Society of Hospital Pharmacists, Inc.; selected categories reproducedwith Permission. 
10 advancedata 

Technical notes 

Source of data and sample design 

The estimates presented in this report are based on 

data collected during 1981 by the National Center for 

Health Statistics by means of the National Ambulatory 

Medical Care Survey (NAMCS). The target universe 

of NAMCS comprises office visits made by ambulatory 

patients to non-Federal physicians who are principally 

engaged in office-based, patient-care practice. Visits to 

physicians practicing in Alaska and Hawaii are excluded 

from the range of NAMCS, as are visits to physicians 

who specialize in anesthesiology, pathology, and radiology. 

NAMCS uses a multistage probability sample design 

that involves a stepwise sampling of primary sampling 

units (PSU’S), physicians’ practices within PSU’S, and 

patient visits within physicians’ practices. For 1981 a 

sample of 2,846 physicians was selected from master 

files maintained by the American Medical Association 

and the American Osteopathic Association. The physician response rate was 77.5 percent. Sampled physicians were asked to complete Patient Records (figure 1) 

for a systematic random sample of office visits made 

during a randomly assigned weekly reporting period. 

Telephone contacts were excluded. During 1981, responding physicians completed 43,366 Patient Records, 

on which they recorded 46,424 drug mentions. Characteristics of the physician’s practice, such as primary 

specialty and type of practice, were obtained during an 

induction interview. The National Opinion Research 

Center, under contract to the National Center for Health 

Statistics, was responsible for the field operations of the 

survey. 

Sampling errors and rounding of 

numbers 

The standard error is primarily a measure of the 

sampling variability that occurs by chance because only 

a sample, rather than the entire universe, is surveyed. * The r;lative standard error of an estimate is obtained by 

dividing the standard error by the estimate itself and is 

expressed as a percent of the estimate. Relative standard errors of selected aggregate visit statistics are shown 

in table I. Standard errors for estimated percents of 

visits are shown in table II. Similar standard errors for 

drug statistics and percents are shown in tables 111and 

IV. Tables I and II should be used to obtain the standard 

error of a specific drug mention (for example, Dyazide). 

Tables III and IV should be used to obtain the standard 

error of a group of drug mentions (for example, all antibiotics). 

Estimates of office visits have been rounded to the 

nearest thousand. For this reason detailed figures within 

tables do not always add to totals. Rates and percents 

were calculated on the basis of original, unrounded 

figures and will not necessarily agree precisely with 

percents calculated from rounded data. 

Table 1. Approximate relative standard errors of estimated number of office 

visits based on all physician specialties NAMCS, 1981 

Relative 

Estimated number of office visits standard 

in thousands error in � percent 

27,3 

19.5 

14.1 

9.4 

7.3 

5,9 

4.9 

4.5 . 

4.1 

Example of use of table: An aggregate estimate of 75,000,000 visits has a relative 

standard error of 4.7 percent, or a standard error of 3,525,000 visits (4,7 percent of 

75,000,000). 

Table Il. Approximate standard errors of percents of estimated numbers of office visits based on all physician specialties NAMCS, 1981 

Estimated percent Base of percent 

(number of office visits in thousands) 

7 or 99 5 or 95 10 or90 20 or 80 30 or 70 50 

Standard error in percent 

500 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 5.9 8.1 10.8 12.4 13.5 

1,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 4.2 5.7 7.6 8.7 9.5 

2,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 2.9 4.0 5.4 6.2 6.7 

5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.8 1.9 2.6 3.4 3.9 4.3 

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.6 1.3 1.8 2.4 2.8 3.0 

20.000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

100,000 . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . 

. 

. . . . . . . 0.4 

0.3 

0.2 

0.9 

0.6 

0.4 

1.3 

0.8 

0.6 

1,7 

1.1 

0,8 

2.0 

1.2 

0.9 

2.1 

?.3 

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . . 0.1 0.2 0.3 0.3 0.4 0.4 

1.0 �

Exampieofuse oftable:An estimate of 30 percent based on an aggregate of 15,000,000 visits has a standard error of 2.4 percent. ora relative standard error of a percent (2.4 percent + 30 \ 

percent). 
dwlcdab 11


Table Ill. Approximate relative standard errors of estimated number of drug 

.- mentions based on all physician specialties NAMCS, 1981 

Relative r Estimated number of drug mentions standard 

in thousands error in 

percent 

27.3 

19.7 

13.2 

10.1 

8.2 

6.8 

6.2 

5.8 

5.7 

Example of use of table: An aggregate esttmate of 75,000,000 drug mentions has a relative standard error of 6.5 percent, ora standard error of4,875,000 mentions (6.5 percent 

of 75,000,000). 

Definitions of terms 

An ambzdatorypatientis an individual seeking personal health services who is neither bedridden nor currently admitted to any health care institution on the 

premises. 

A physician eIigibleforNAMCS is a duly licensed 

doctor of medicine (M.D.) ordoctorof osteopathy (D. O.) 

currently in office-based practice who spends time in 

caring for ambulato~ patients. Excluded from NAMCS 

are physicians who are hospital base@ physicians who 

specialize in anesthesiology, pathology, or radiology; 

physicians who are federally employed physicians who 

treat only institutionalized patien~, physicians employed 

full time by an institutio~ and physicians who spend no 

time seeing ambulatory patients. 

An ofice is a place that physicians identify as a 

location for ambulatory practice. Responsibility over 

time for patient care and professional services rendered 

there generally resides with the individual physician rather 

than with an institution. 

A visit is a direct personal exchange between an 

ambulatory patient and a physician, or a staff member 

working under the physician’s supervision, for the purpose of seeking care and rendering health services. 

A drugmention is the physician’s entry of a pharmaceutical agent ordered or provided—by any route of 

administration-for prevention, diagnosis, or treatment. 

Generic as well as brand-name drugs are included, as 

are nonprescription as well as prescription drugs. The 

physician records all new drugs and continued medications when the patient is specifically instructed during 

the visit to continue the medication. 

Table W. Approximate standard errors of percents of estimated numbers of drug mentions based on all physician specialties NAMCS, 1981 

Base of percent Estimated percent 

(number of drug mentions in thousands) 7 or 99 5 or 95 10 or 90 20 or 80 30 or 70 50 

Standard error in percent 

1,000................................................... 2.7 5.8 8.0 10.7 12.2 13.3 

2,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 4.1 5.7 7.6 8.7 9.4 

5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 2.6 3.6 4.8 5.5 6.0 

20,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.6 1.3 1.8 2.4 2.7 3.0 

100,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.3 0.6 0.8 1.1 1.2 1.3 

600,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.1 0.2 0.3 0.4 0.5 0.5 

Example of use of table: An estimate of 30 percent based on an aggregate of 12,500,000 dmg mentions has a standard error of4.1 percent, ma relative standard error of 13.7 percent (4.1 

percent +30 percent]. 
12 ackincedata 

Recent Issues of Advance Data From Vital and Health Statistics 

No. 88. 1981 Summarw National Ambulatory Medical Care Survey (Issued March 16: 1983) 

No. 87. Drug Utilization in General and Family Practice by Characteristics of Physicians and OffIce Visits: National Ambulatory 

Medical Care Survey, 1980 (Issued March 28, 1983) 

No. 86. Drug Utilization in Ofice Visits to Primary Care Physicians: National Ambulatory Medical Care Survey, 1980 (Issued. 

October 8, 1982) 

SUGGESTED CITATION


National Center for Health Statistics, H. Koch:


Drugs most frequently used in office practice,


National Ambulatory Medical Care Survey, 1981.


Advance Data From Vital and Health Statistics,


No. 89, DHHS Pub. No. (PHS) 83-1250. Public


Health Service, Hyattsville, Md. April 1983,


U.S. DEPARTMENT OF HEALTH


AND HUMAN SERVICES


Public Health Service


National Center for Health Statistics


3700 East-West Highway


Hyattsville, Maryland 20782


OFFICIAL BUSINESS


PENALTY FOR PRIVATE USE, $300


To receive this publication regularly, contact the


National Center for Health Statistics by calling


301–436–NCHS


DHHS Publication No. (PHS) 83–1250


No. 85. Summary Data From the National Inventory of Phar- 0 

macists: United States, 1978–79 (Issued October 8, 1982) 

No. 84. Blood Pressure Levels and Hypertension in Persons Ages 

6-74 Years: United States, 1976-80 (Issued 

COPYRIGHT INFORMATION 

This report may be reprinted 

permission. 

POSTAGE ANO FEES PAl O 

U.S. DEPARTMENT OF HHS 

HHS 396 

THIRD CL4SS 

BULK RATE 

October 8, 1982) 

without further *

.
 0°U.S.MAIL