Unpacking the Great Acid Reflux Scam
One of the more depressing parts of being an awake physician in the medical system is reading the drug lists of the patients you see and realizing how many prescriptions they are on that do not benefit them, and in many cases harm them
Presently, 68% of U.S. adults are estimated to have at least one prescription and on average, American adults are on four different medication.
Since doctors are extremely reluctant to terminate existing prescriptions, this creates a scenario where people get placed on more and more drugs as they age (some of which are for treating the side effects of other drugs they are taking).
This situation is even worse for the elderly, who have more time to be put on an increasing number of medications, and due to their altered physiology, are also the most vulnerable to the harmful effects of those medications.
For example, from 2009-2016, after two billion office visits were assessed, it was found that for adults over 65, 65.1 percent were on two or more drugs, 48.9 percent were on four or more, and 36.8 percent were on more than five (with the highest use occurring in the oldest Americans).
One of the best illustrations of the problem came from a study that compared 119 disabled elderly adults living in nursing homes to 71 matching controls.
These patients (on average, were on 7.09 medications) were screened for which of their medications clearly met the existing criteria for being discontinued (on average 2.8 per patient). After those medications were discontinued in the test group, when compared to the controls who remained on all of their existing prescriptions, it was found that:
•The death rate dropped by 53 percent (in one year, 45 percent of the control group died, whereas 21 percent of the test subjects died).
•The annual rate of hospital referrals dropped by 60.7 percent (30 percent of the controls vs. 11.8 percent of the study).
•Not surprisingly, there were also significant cost savings from withdrawing the unneeded medications.
In short, doing nothing except terminating some of the most egregious prescriptions for our elders (who often lack the autonomy to refuse their prescriptions) resulted in a 23 percent reduction in their death rate.
When you consider that many of these drugs are approved for much smaller reductions of the death rate, and that they frequently have a variety of other concerning side effects (e.g., triggering dementia), the absurdity of this situation (e.g., that this pivotal study never changed how we practice medicine) becomes apparent.
For example, almost everyone is put on statins—especially as they get older. Yet in trials evaluating statins, for instance, their effect on 50-75 year old patients’ risk of heart disease, statins caused a 0.4% reduction in the annual risk of a major cardiovascular event (most of which are not fatal) and no benefit in the overall death rate.
Likewise, according to the existing trials (which are almost certainly biased to favor the pharmaceutical companies funding them), it was found on average that taking a statin for five years would increase your expected lifespan by three to four days.
In contrast, statins are notorious for causing adverse effects which affect at least 20 percent of recipients. These effects include cognitive impairment and dementia, personality changes, loss of sensation throughout the body, and significant muscle weakness or muscle aches.
This seems absurd until you also consider that statins are also one of the most profitable drug markets in existence.
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Header image: Gastroenterology Consultants of San Antonio