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Wednesday 21 March 2018

Drugs and the Health of Older People. Is it 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 'over-medication' 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 was amazed at how many drugs the residents were taking; and despite they never appeared to get better! By that time I had already realised that conventional medicine was dangerous, but still hadn't fully recognised how ineffective it was 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 'over-medication' going on, and the clear implication is that it was this medication, the drugs given to older people, that were causing the problem, and that by reducing them there will be fewer hospital admissions.

So the review recognised 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 have led to unnecessary hospital admissions.

Back in the 1980's, when I began discussing the drugging 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 a real 'illness', and what was a 'side effect' of the drugs residents were taking,
  • 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 had been 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 engaged,
  • The medical round was shorter, so staff had less work to do!
  • Doctors, even those who had initially been sceptical, were relieved that they no longer faced the pressure and the expectation that they should prescribe drugs for every ill.
Before announcing its review, NHS England has trialed the policy in 37 care homes, and had seen an annual drug cost saving of £249 per patient. 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 over-medicated 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 any better, and that their health suffered as a direct result of side effects of those drugs.

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

As conventional medicine sinks further into abject failure, as its drug and vaccines fail, as drugging makes us sicker, and leads to epidemic levels of chronic disease, as the NHS staggers under the pressures all this produces on resources, we all need to consider doing the same thing.

Moreover, it is important that we do so before becoming too old, before we find ourselves in residential or nursing care, taking a multitude of drugs that not only don't work, but through their side effects, make us sicker, and ultimately contribute to our dependency and death.