Americans see their doctors about 1 billion times a year. Roughly 85% of adults visit their physicians at least once during the year. That’s an average of about 3.2 visits per person. A primary reason people visit their doctor is to access or renew a prescription drug. Nearly three-fourths (72%) of physician visits result in drug therapy. The number of drugs prescribed annually adds up to about 1 billion.
Drug therapy is the most efficient way to treat diseases and conditions. Drugs are the best bargain in health care, especially OTC drugs. Half of Americans have taken a prescription drug in the past month. One-fourth have taken three or more, while 13.5% take five or more. I often said that a physician reaching for a prescription pad (OK, that’s old school nowadays) is the signal that the visit is over. Sometimes – too frequently really – a physician hands patients free medication samples, mostly because people like free stuff. Prescriptions aren’t always beneficial, however.
Seniors are overmedicated. Ninety percent of seniors, age 65 or above, take a prescription drug. The average number of drugs seniors take increased 43%, from 3 in 2000 to 4.3 in 2020. Too often seniors get on prescription drugs and never get off them. They just add to the total over the years. Experts say this is because with numerous doctors, no one physician is privy to all the medications a senior is on. Also, primary care physicians may worry about stepping on toes of other doctors, mainly specialists, by questioning whether some drugs should be discontinued.
A Wall Street Journal analysis of Medicare data found around 17% of seniors were prescribed eight (8) or more medications, or about 7.6 million seniors. Nearly 4 million took 10 drugs or more in the analysis, while 419,000 seniors were prescribed 15 or more drugs. These findings are not surprising. In an article from 15 or 20 years ago, a physician interviewed opined that when a senior is on a dozen medications, half are to counteract the side effects of the other half. More from WSJ:
For years, Barbara Schmidt’s family feared an illness was behind a pattern of terrifying falls that repeatedly landed the 83-year-old great-grandmother in surgery with broken bones. Instead, Schmidt’s frequent tumbles might have been tied to something else: medications intended to make her better.
Schmidt, who lives with her husband of 65 years in Lewes, Del., filled prescriptions for more than a dozen different drugs in the past year, according to pharmacy and medical records.
Ms. Schmidt is relatively healthy, working part time and pursuing a hobby of crafts. Over the years she has had a few surgeries, such as a hip replacement. Doctors gave her pain medications, among others. More from WSJ:
Doctors layered on medications to help.
Among the earliest was gabapentin, which she says started about a decade ago for lingering back problems. The drug seemed to help with her pain, and she wanted to continue her active life, so she kept taking it, getting up to three 300-milligram doses a day.
For years, records show, Schmidt also took diazepam for anxiety. The drug is better known as Valium, from the class of medications called benzodiazepines.
Some of these drugs are contraindicated, not to be taken together. Indeed, WSJ found some of the medications taken by those seniors who took a large quantity of different time drugs, at least one was often not a drug that should be used in senior adults.
Many doctors recommend an annual review of all the drugs seniors are on to assess whether they still need to be on all of them. The woman in the anecdote above had such as assessment, called medication therapy management. It is a requirement under Medicare. Yet, in WSJ’s analysis, comprehensive reviews did not affect the average number of drugs prescribed to patients. Seniors should take a list of all their medications, along with the dose, to their doctors periodically and ask whether they still need them all.
Read more at WSJ: America’s Seniors Are Overmedicated