A report by the state’s largest health insurance provider says Iowans in larger cities are more likely to use prescription drugs for a cough and cold than over-the-counter medication. The report by Wellmark Blue-Cross/Blue Shield says the use of prescription cough and cold drugs is highest in such cities as Osceola, Council Bluffs and Des Moines. It’s lower in some smaller towns like Decorah, Rock Rapids, Le Mars, Waukon and Cherokee. Wellmark’s chief medical officer, Dale Andringa (AN’-dring-uh), says part of the reason for the difference is better availability of doctors to write a prescription in larger cities. Dr. Andringa also believes age plays a role, as he says younger people probably use more prescription drugs and larger communities tend to have a younger population. He says there’s another factor. He says the survey points out that physician prescription patterns vary according to individual doctors and often times from groups of doctors from one community to the next. Andringa says the doctor’s school may have some influence, too. He says it can be partially determined by where and how they were trained, but he says their patterns most often developed over time based on their community. He says one other thing the study points out is that physicians are many times prescribing more costly prescription drugs.Andringa says they are using quite a few prescription cold medicines when, in most cases, there’s a very legitimate over-the-counter remedy they can purchase at less cost. To view the report, surf to www.wellmark.com.