More illness and less disease? A 20-year perspective on chronic disease and medication

Background: The implication of medication is that a drug is given against an illness. Over the last few decades an expanding number of drugs have appeared that focus on reducing risk factors and lifestyle conditions. Aims: To investigate the apprehension in respect of chronic disease among the working population in a Swedish community in 2000 compared with 1980. Methods: In 1980 and 2000 an analogous questionnaire assessing chronic diseases and medication was mailed to 250 randomly selected persons from a local population between 25 and 70 years of age. Results: Some 80% of the persons (n=201) replied in 1980 and 78% (n=195) in 2000. Individuals declaring a chronic disease increased from 23% (46/201) in 1980 to 39.5% in 2000 (p=0.0005). Corresponding figures for men were 20.6% (20/97) in 1980 and 40.8% (40/98) in 2000 (p=0,004) and for women 25.0% (26/104) in 1980 and 38.1% (37/97) in 2000 (p=0.064). Persons who regularly see a doctor increased from 13% to 26% (p=0.002) and the use of drugs for chronic diseases increased from 19% to 33% (p=0.002). In 2000 an average of 2.3 drugs per person were used among those with a chronic disease, an increase of 53% since 1980. Conclusion: Stated chronic diseases and use of drugs for such diseases increased greatly between1980 and 2000. Prescribing drugs for a "risk" with no apparent illness may be confused with the remedy for an illness