According to the Lown Institute, a Massachusetts-based think tank focused on health care policy, American seniors are overmedicated – and this trend could be sending millions of them to emergency rooms due to serious side effects and interactions.
According to a press release published late last month, an average of 750 elderly patients in the U.S. winds up in the hospital every day because of side effects from one or more of their medications. Most of them are taking at least five different prescription drugs on a daily basis, and one-fifth of seniors take 10 or more. The Lown Institute predicts that if current trends continue, an estimated 4.2 million people age 65 and older will suffer serious injuries, and 150,000 could die prematurely. They are now sounding the alarm to patients as well as health care professionals. De-prescribing could not only prevent these tragedies – it could save society an estimated $62 billion on otherwise unnecessary hospital visits.
It is not the first time that concerns about overmedication have been raised. In October 2010, U.S. News and World Report published an article warning that Americans across the board are taking too many prescription pills, and those who do could face health consequences later in life. In 2017, Washington D.C. physician Dr. Ranit Mishori wrote an editorial for the Washington Postencouraging his colleagues to think twice before writing prescriptions – and “de-prescribe” when necessary.
On average, Americans take 12 different medications every year for various conditions, including hypertension, diabetes, acid reflux, and other disorders that could be treated with diet and lifestyle changes. Since the 1970s, the amount spent on prescription drugs has doubled, accounting for 10 cents out of every health care dollar. By some estimates, current spending on prescription medications in the U.S. is as much as $400 billion per year.
While price gouging by Big Pharma certainly accounts for part of this, the fact is that for some time the medical profession, as well as the general public, have had what the Lown Institute calls a “pills for all ills” mindset. The danger is that the chances of experiencing a serious adverse reaction rise by as much as 10 percent with every additional prescription that is taken.
This is why the Lown Institute has released its Eliminating Medication Overload: a National Action Plan. In addition to addressing the entire “culture of prescribing,” the plan also looks at educating clinicians and patients so as to enable them to make informed decisions about the drugs they prescribe.
Another problem they have identified is a failure to communicate, or the “fragmentation of care.” When a patient sees multiple specialists, they may prescribe something to treat what looks like a new illness, but may in fact be the side effect of a different medication. This can lead to a vicious cycle, resulting in injury and premature death.
Significantly – given the behaviors of Big Pharma – the Lown initiative also seeks to limit the influence of drug companies by restricting the activities of sales representatives and direct-to-patient advertising.
Shannon Brownlee, a Lown executive and driving force behind the initiative, says, “We want patients to think it’s OK to question whether they need to be on all the drugs they’re on [and] doctors to think twice before prescribing new medicines. We want it to be a normal part of a primary care physician’s practice to regularly see if there’s a way to get patients off one or more drugs.”