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Medication

Many people take drugs, yet do they really need them?

Elaine Godley

Last Update a year ago

I am 68 years old and disappointed to learn that people aged 68 are typically taking multiple medications, with recent studies showing a significant increase in medication use among older adults.

The median number of prescription medications used by adults aged 65 and older doubled from 2 to 4 between 1988 and 2010[1].

More recent data suggests that nearly half of all older people now take at least five medicines[2].

Reasons for Increased Medication Use

1. **Multiple Chronic Conditions**: Older adults often have several coexisting chronic health conditions that require medication management[4].

2. **Cardioprotective Medications**: There has been a rise in the use of statins, antihypertensives, and antidiabetics, which constitute a significant portion of prescriptions for older adults[1].

3. **Preventive Care**: Many medications are prescribed for preventive purposes, such as reducing the risk of heart disease or stroke[3].

4. **Longer Life Expectancy**: As people live longer, they are more likely to develop conditions that require ongoing medication[2].

Common types of medications used by adults in this age group include:-

Antihypertensives (for high blood pressure)

Lipid-lowering drugs (for high cholesterol)

Antidiabetic agents

Antiplatelet agents

Medications for peptic ulcer and gastroesophageal reflux[3][5]

It's important to note that while medication use is common and often necessary, there are concerns about polypharmacy (the use of multiple medications) in older adults.

This can increase the risk of adverse drug reactions, drug interactions, and other complications[4]. Therefore, regular medication reviews with healthcare providers are crucial to ensure appropriate and safe medication use in this age group.

Citations:

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC4573668/

[2] https://theconversation.com/medication-nation-new-research-shows-nearly-half-of-all-older-people-now-taking-at-least-five-medicines-84879

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC8971522/

[4] https://www.hopkinsmedicine.org/health/wellness-and-prevention/polypharmacy-in-adults-60-and-older

[5] https://www.cdc.gov/nchs/products/databriefs/db347.htm

[6] https://jamanetwork.com/journals/jama/fullarticle/183125

[7] https://academic.oup.com/ageing/article/47/2/220/4237359?login=false

[8] https://pmc.ncbi.nlm.nih.gov/articles/PMC8294219/

Iatrogenic Deaths are Increasing Worldwide

Iatrogenic deaths, which are deaths caused by medical errors or adverse effects of medical treatment, represent a significant proportion of deaths worldwide.

While exact figures vary across studies and regions, recent estimates suggest that iatrogenic deaths account for a substantial number of fatalities globally.

According to a 2018 review, iatrogenesis is considered the fifth leading cause of death in the world[1].

Specifically, adverse drug reactions (ADRs) are estimated to cause about 5-8% of deaths worldwide[1].

In some countries, ADRs are even reported as a leading cause of death[1].

More recent global data from 2013 indicates that an estimated 142,000 people died from adverse effects of medical treatment, which represents an increase of 51% from 94,000 in 1990[2].

However, it's important to note that these figures may not capture the full extent of iatrogenic deaths due to challenges in reporting and classification.

In the United States, various studies have attempted to quantify iatrogenic deaths:

1. A Johns Hopkins study published in 2016 estimated that more than 250,000 deaths per year are due to medical error in the U.S., which would make it the third leading cause of death after heart disease and cancer[4].

2. Another analysis suggests that medical errors could account for up to 9.5% of all deaths each year in the U.S.[4].

3. A more conservative estimate from a 2020 meta-analysis by Yale University researchers found evidence of about 22,000 preventable deaths annually, primarily in people with less than three months to live[5].

It's crucial to understand that these figures are estimates and subject to debate within the medical community. The true proportion of iatrogenic deaths is challenging to determine due to various factors, including differences in reporting methods, classification systems, and the inherent complexity of attributing deaths to medical errors.

While the exact proportion remains uncertain, the data underscores the importance of continued efforts to improve patient safety and reduce preventable harm in healthcare settings worldwide.

Citations:

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC6060929/[2] https://en.wikipedia.org/wiki/Iatrogenic[3] https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death[4] https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/[5] https://healthjournalism.org/blog/2023/07/medical-errors-are-the-third-leading-cause-of-death-and-other-statistics-you-should-question/[6] https://pubmed.ncbi.nlm.nih.gov/28186008/[7] https://www.who.int/news-room/facts-in-pictures/detail/patient-safety[8] https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

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