Wednesday, 21 March 2018

Drugs and the Health of Older People. Time for a Change?

NHS England has announced there is to be a pharmacist-led medicine review on 180,000 care home residents. The aim is to reduce the 'overmedication' of older people in care homes, and to reduce unnecessary hospital stays. The programme will require the recruitment an additional 240 pharmacists and pharmacy technicians costing £20 million.

In the late 1980's I managed two residential homes for older people. I remember being amazed at how many drugs the residents were taking, and despite this noticing that they never appeared to get better. By that time I had realised that conventional medicine was dangerous, but still hadn't realised that it was largely ineffective as well.

In announcing the review NHS England said that many residents in nursing and residential homes have "multiple long term conditions" and "take an average of seven medications daily". In order to justify spending £20 million there must indeed be a considerable amount of 'overmedication' going on, although the clear implication is that by reducing the drugs given to older people there will be fewer hospital admissions.

So the review recognises two things, if only tacitly. Older people have 'multiple long-term conditions' which drugs do not deal with effectively. And that the amount of drugs prescribed for older people lead to unnecessary hospital admissions.

When I began discussing the issue with staff, residents, their relatives, and doctors several conclusions were quickly reached.
  • the drugs were not making the residents better
  • no-one knew with any certainty what was an illness, and what was a side effect of a drug
  • no-one had any idea about the potential drug interactions, and what problems they were causing
So it was agreed that each resident should have a drug review, that residents, relatives, staff and doctors would be involved, and decisions would be made about whether the drugs were necessary. Within 3 months the drug round was reduced by over 50%. The result seemed to please everyone.
  • Residents and relatives could see no real difference in their health, except that many were brighter and more involved.
  • The medical round was shorter, so staff had less work to do!
  • Doctors, even those who had been sceptical to begin, were relieved that they no longer faced the pressure and expectation to prescribe drugs for every ill.
NHS England has trialled the policy. It reported that the trials, covering 37 care homes, had seen an annual drug cost saving of £249 per patient, across 37 care homes. They also reported a 21% reduction in emergency hospital admissions, and a 30% drop in ambulance call outs. So the Chief Executive of NHS England, Simon Stevens, is reported as saying this: 

               "There’s increasing evidence that our parents and their friends - a whole generation of people in their 70s, 80s and 90s - are being overmedicated in care homes, with bad results. Let’s face it- the policy of "a pill for every ill" is often causing frail older people more health problems than it’s solving."

What no-one recognises, or perhaps what conventional medicine refuses to recognise, is what I learnt nearly 30 years ago from my little medication review - that pharmaceutical drugs did not make older people better, and that the health of older people suffered as a direct result of unnecessary and unhelpful drugging.

It was at that time that I decided to abandon conventional medicine, to refuse to take pharmaceutical drugs and vaccines, and to discover a safer, more effective medical therapy.

As conventional medicine sinks into abject failure, as its drug and vaccines fail, as drugging is making us sicker, and leading to epidemic of chronic disease, as the NHS cannot cope with the pressures all this produces on resources, everyone needs to do the same thing. And it is important to do so before becoming too old, and find themselves in residential and nursing care, taking a multitude of drugs that do not work, and through their side effects, make us sicker - and eventually contribute to our deaths.