Overprescription of drugs


  • Overmedication
  • Medication overload
  • Prescribing cascade
  • Reluctance to de-prescribe
  • Prescription of unsuitable medications
  • Unnecessary polypharmacy

Nature

Polypharmacy is the technical term for taking multiple medicines. Polypharmacy, specifically through overprescribing, has become a huge public health problem. Multiple medicines (anything more than 2 or 3 medicines) could produce a dangerous mix of drug interactions and incompatibilities. Promotional pressure, patient expectations and belief in the basic benign nature of drugs lead to overprescribing by physicians.

Incidence

Experts estimate that 4.25 billion prescriptions (averaging 30 pills) will be dispensed in 2019 at retail pharmacies in the USA. That does not count the medicines administered in hospitals or retirement communities. It also ignores over-the-counter products and dietary supplements. This means that Americans likely swallow way more than 100 billion pills annually. Some swallow a handful of pills a day, more pronounced in the elderly: more than four in ten older adults take five or more prescription medications a day, an increase of 300 percent over the past two decades. Nearly 20 percent take ten drugs or more.

It is estimated that only half of the USA consumer's drug bill is medically justified. Physicians prescribe antibiotic to patients with colds knowing that they are ineffective against the common cold. This overprescribing has caused an epidemic of adverse reactions and doctor-induced diseases. The death rate from these diseases in the USA is estimated at between 30,000 and 130,000 per year. The development of drug resistance bacterial strains have emerged and are estimated to cause an additional unnecessary 100,000 deaths a year, particularly in hospitals. A number of diseases are being detected which are caused by treatments 20 or 30 years earlier or even to the patient's mother. For example, a woman may develop cervical cancer if their mother was treated with diethylstilbestrol during her pregnancy 20 years earlier.

Claim

  1. If nothing is done to change current practices, medication overload will lead to the premature deaths of at least 150,000 older people in the U.S. over the next decade and it will reduce the quality of life for millions more.


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