GESTIÓN EN SALUD PÚBLICA: Prescription of psychotropic drugs doubles for US retirees

sábado, 18 de febrero de 2017

Prescription of psychotropic drugs doubles for US retirees

Prescription of psychotropic drugs doubles for US retirees

by Xavier Symons | 18 Feb 2017 |

The number of US retirees taking three or more psychotropic drugs has doubled between 2004 and 2013, according to a new paper published in the Journal of the American Medical Association.

The study, lead by researchers from the University of Michigan and Columbia University, found that doctors were approximately 150% more likely to prescribe psychiatric, sleep, or pain medications to patients over the age of 65.

The researchers reviewed annual government surveys of office-based doctors, and focused on the prescription of at three three of a list of psychiatric, sleep and pain medications like Valium, Prozac, OxyContin and Ambien.

“Between 2004 and 2013, annual polypharmacy visits by adults 65 years or older increased from 1.50 million...to 3.68 million”, the researchers state.

“The biggest jump was in rural areas,” Dr. Mark Olfson, one of the principal authors of the paper, told the New York Times. “[This] suggests to me that the increases partly reflect doctors and patients falling back on medications when they have little access to other options”, he said.

Experts expressed concern at the findings, saying that polypharmacy -- the prescribing of three or more psychiatric drugs -- can bring dangerous side-effects.

“I was stunned to see … that despite all the talk about how polypharmacy is bad for older people, this rate has doubled,” Dr. Dilip Jeste, a professor of psychiatry and neurosciences at the University of California, San Diego, told the New York Times.

The researchers found that nearly half -- almost 46 percent -- of people with at least three prescriptions had no diagnosis of mood, chronic pain or sleep problems.

The finding mirror the results of another study, published in January, which found that more than half of older patients who had been prescribed an antidepressant for depression by their primary care physician did not meet the criteria for Major Depressive Disorder.

Winston Churchill was once voted the “greatest Briton of all time” in a BBC poll, edging out Isambard Kingdom Brunel (who?), Lady Diana, Shakespeare and John Lennon. Now, in addition to his gifts as a statesman and politician, orator and historian (and artist), we have been reminded that he helped to popularise science as well.

As reported in Nature, an historian has discovered an 11-page manuscript which Churchill penned in 1939 but never published, speculating about life on other planets. It turns out that the great man was deeply interested in modern science and followed developments keenly. Gazing at the gathering storm, he wrote pessimistically:

“I, for one, am not so immensely impressed by the success we are making of our civilization here that I am prepared to think we are the only spot in this immense universe which contains living, thinking creatures, or that we are the highest type of mental and physical development which has ever appeared in the vast compass of space and time.”

But despite the reminder that Churchill was a fan of science, it’s also good to remember that he believed that there were moral limits to science. In one of his most famous speeches, he foresaw dark days for the world if Germany were to win the War:

If we can stand up to [Hitler], all Europe may be free and the life of the world may move forward into broad, sunlit uplands. But if we fail, then the whole world ... will sink into the abyss of a new Dark Age made more sinister, and perhaps more protracted, by the lights of perverted science. Let us therefore brace ourselves to our duties, and so bear ourselves that, if the British Empire and its Commonwealth last for a thousand years, men will still say, "This was their finest hour."

Science, so Churchill believed, was fascinating, but not good in itself. It had to be governed by morality, lest it become “perverted”. It’s not a bad reminder for us, three generations on, as we enter an era of genetic engineering.