Jeremy Laurance: Bad medicine is also bad for the budget

Tuesday 04 January 2011 01:00 GMT
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A writer and keen tennis player developed a series of medical conditions in his eighties which led to him being prescribed 13 different drugs.

He was losing his mind and "doing almost nothing", according to his wife, until a doctor conducted a detailed review. The drugs were withdrawn one by one and he was left on just six, his mobility and mental state much improved.

This story was told in the Journal of the American Medical Association, which estimated the costs of over-medication – including hospital admissions due to adverse drug events – at more than $80bn (£51bn) a year. Millions are spent providing medicines to mainly elderly patients which make them worse, not better. That is not just bad medicine, it is bad economics.

There is evidence that the more drugs an older person takes, the more likely they are to suffer falls, mental decline, loss of mobility, depression and heart trouble. Often doctors prescribe a new drug to counteract the effects of another.

Patients may see a different doctor each time they attend the practice. Often they cannot remember all the drugs they are taking and if no one has a complete list the risk of adverse interactions is increased.

Elderly patients receiving multiple prescriptions should have their drugs reviewed at least annually, and any symptom in them should be considered a drug side-effect until proved otherwise. These two measures could improve their health – and save the NHS millions.

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