title: Temporal trends in dietary supplement prescriptions of United States military service members suggest a decrease in pyridoxine and increase in vitamin D supplements from 2005 to 2013.
abstract: Dietary supplements (DSs) can be obtained over-the-counter but can also be prescribed by health-care providers for therapeutic reasons. Few studies have documented this later source despite the fact that 79% of physicians and 82% of nurses have recommended DSs to patients. This investigation assessed prevalence and temporal trends in oral DS prescriptions filled by all United States service members (SMs) from 2005 to 2013 (n = 1 427 080 ± 22 139, mean ± standard deviation (SD)/y). We hypothesize that there would be temporal variations in specific types of DSs. Data obtained from Department of Defense Pharmacy Data Transaction System were grouped by American Hospital Formulary System pharmacologic-therapeutic classifications and prevalence examined over time. About 11% of SMs filled one or more DS prescriptions of 235 180 ± 4926 (mean ± SD) prescriptions/y over the 9-year period. Curve-fitting techniques indicated significant linear declines over time for multivitamins (P = .004), iron preparations (P < .001), antacids (P < .001), and vitamin B and B complex vitamins (P < .001). There were significant quadratic trends indicating a rise in early years followed by a leveling off in later years for replacement preparations (P < .001) and vitamin C (P < .001). There were significant quadratic trends (P < .001) for vitamin E indicating a decline in early years and leveling off in later years, and vitamin D indicating little change in early years followed by a large rise subsequently (P < .001). This study identified temporal trends in specific DS categories that may be associated with changing perceptions of prescribers and/or patients of the appropriate roles of DSs in medicine and public health.
authors.affiliation: US Army Research Institute of Environmental Medicine, Natick, MA, 01760, USA; US Army Public Health Center, Aberdeen Proving Ground, MD, 21010, USA; Oak Ridge Institute for Science and Education, Belcamp, MD, 21017, USA. Electronic address: joseph.j.knapik.ctr@mail.mil.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Knapik
authors.affiliation: Office of the US Army Surgeon's General, Pharmacovigilance Center, Falls Church, VA, 22041, USA. Electronic address: rosenie.thelus.civ@mail.mil.
authors.forename: Rosenie
authors.initials: R
authors.lastname: T Jean
authors.affiliation: US Army Research Institute of Environmental Medicine, Natick, MA, 01760, USA; Oak Ridge Institute for Science and Education, Belcamp, MD, 21017, USA. Electronic address: krista.g.austin.ctr@mail.mil.
authors.forename: Krista G
authors.initials: KG
authors.lastname: Austin
authors.affiliation: US Army Public Health Center, Aberdeen Proving Ground, MD, 21010, USA. Electronic address: ryan.a.steelman.ctr@mail.mil.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Steelman
authors.affiliation: Office of the US Army Surgeon's General, Pharmacovigilance Center, Falls Church, VA, 22041, USA. Electronic address: julia.f.gannon.civ@mail.mil.
authors.forename: Julia
authors.initials: J
authors.lastname: Gannon
authors.affiliation: US Army Research Institute of Environmental Medicine, Natick, MA, 01760, USA; Oak Ridge Institute for Science and Education, Belcamp, MD, 21017, USA. Electronic address: emily.k.farina.ctr@mail.mil.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Farina
authors.affiliation: US Army Research Institute of Environmental Medicine, Natick, MA, 01760, USA. Electronic address: harris.r.lieberman.civ@mail.mil.
authors.forename: Harris R
authors.initials: HR
authors.lastname: Lieberman
mesh_terms: D000863:Antacids; D001205:Ascorbic Acid; D019587:Dietary Supplements; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007501:Iron; D008297:Male; D008889:Military Personnel; D010818:Practice Patterns, Physicians' / Q000639:trends; D011736:Pyridoxine; D014131:Trace Elements; D014481:United States; D014803:Vitamin B Complex; D014807:Vitamin D; D014810:Vitamin E; D014815:Vitamins
chemical_list: D000863:Antacids; D014131:Trace Elements; D014815:Vitamins; D014803:Vitamin B Complex; D014807:Vitamin D; D014810:Vitamin E; D007501:Iron; D011736:Pyridoxine; D001205:Ascorbic Acid
keywords: Antacids/absorbents; Cathartics/laxatives; Iron preparations; Minerals; Multivitamins; Vitamins