gms | German Medical Science

11. Jahrestagung 2004 der GAA

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

30.09. bis 01.10.2004, Jena

Co- and Multi-medication of OTC- and Rx-Drugs in Germany

Meeting Abstract

  • corresponding author presenting/speaker H.-U. Melchert - Robert Koch-Institute, Berlin
  • H. Knopf - Robert Koch-Institute, Berlin
  • E. Pabel - Robert Koch-Institute, Berlin
  • M. Braemer-Hauth - Robert Koch-Institute, Berlin

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA) e.V.. 11. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie (GAA) e.V.. Jena, 30.09.-01.10.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gaa26

The electronic version of this article is the complete one and can be found online at:

Published: September 30, 2004

© 2004 Melchert et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Representative usage data of all drugs in the whole population are not easily available. Co- and multi-medication often is not considered adequately in epidemiological studies. Five German National Surveys (from 1984 to 1999) cover more than 24000 study participants and are representative for the adult German population under ambulant care. The national survey for children and adolescents (KiGGS) is currently under way and will cover approximately 18000 study participants aged 0 - 18 years at 150 sample points in Germany.


Firstly to gain valid information concerning drug usage for all drugs in the population and secondly to explore the patterns of co-medication of Rx- and OTC-drugs and to look for the amount of self-medication. As multi-medication of drugs often is accompanied with higher rates of adverse drug reactions, this knowledge will be of great value for drug safety.


The standardised questionnaire which was used in all former surveys was adapted in the last two surveys to a software tool to perform a computer-assisted personal interview by physicians. Data concerning the younger age groups (up to 13 years) are gained by asking their parents. Older age groups are asked directly. Medical examinations and laboratory measurements of blood, serum and urine are done for all study participants. Drug usage information is collected in two data banks, one of them patient-oriented and the other drug-oriented.


Our epidemiological instruments gave valid information concerning all aspects of drug usage. Rx-drugs had a high coincidence with the German GKV-index (reimbursement data of the 'Gesetzliche Krankenversicherung'). The surveys revealed clear differences between age- and sex-groups in their co- and multi-medication patterns of OTC- and Rx-drugs in many ATC-groups especially for analgesics, psychotropics, cardiac drugs, antihypertensives, contraceptives and thyroid drugs. Additional laboratory data enable us to create reference values for clinical chemistry and haematological data for adults, adolescents and children. For selected substances e.g. acetylsalicylic acid, tocopherols (Vitamin E) and caffeine the development of serum concentrations from 1984 to 1999 will be presented.


All surveys show that valuable information can be gained by combining drug-usage data with medical examination and laboratory data as well as serum concentrations of selected substances. Thorough knowledge of the usage patterns of co- and multi-medication of drugs, which is very common especially in old-aged, can promote drug safety.

Conflict of Interest Statement

All authors are working in the Robert Koch-Institute, financed by the German taxpayers' money which is used by the Ministry of Health and Social Safeguarding, with no sponsoring from other funds or industrial groups.