Docs prescribing meds despite evidence of ineffectiveness

Here's how hooked on pills we are: Docs give them – and patients take them – even when they don't work.

Just take a look at the latest study on elderly patients who've suffered from a specific kind of heart failure: It turns out none of the drugs they take help their condition.

The study, carried out at the Cedars-Sinai Medical Center in Los Angeles and published in the American Journal of Cardiology, looked at 142 people with diastolic heart failure and an average age of 87. Within five years, 69 percent of them had died no matter what they took.

Statins, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta blockers, diuretics, calcium channel blockers, nitrates and digoxin – take your pick, none of them made a bit of difference when it came to who lived and who died.

Patients who suffer from diastolic heart dysfunction represent about half of the 5 million people who suffer from heart failure. Yet no treatments are tailored to them. The guidelines offered by both the American Heart Association and the American College of Cardiology are aimed entirely at the other half, those who suffer from systolic heart failure.

Diastolic dysfunction – which means the heart's problems come when it's relaxed, not when it's pumping – is more common among the elderly and women, but the Cedars- Sinai researchers say it is often not properly diagnosed.

And now we know that even when it is properly recognized, the treatments they're given amount to little more than lip service: "Here's a few pills that won't do anything. Have a nice day."

So if these drugs aren't helping, then we need to ask the other question: Are they hurting?

I'd say yes.

The number of drugs our elderly are forced to swallow is utterly ridiculous and patently absurd. Many of these pills, including most heart medications, come with side effects – and some of those are pretty nasty.

And let's not forget that simply having to take all those drugs, at different points in each day, brings with it a special stress of its own. Most of us know folks who have not just a shelf or cabinet for their meds, but an entire dresser drawer full of them.

Every week, they dutifully go through all those bottles, pulling out all the capsules and tablets they'll need for the week and transferring them to the pillbox that sits on the kitchen counter or next to the bathroom sink.

If that's not necessary, why are we forcing them to do this? If a pill doesn't save a life or preserve the quality of it, then it's doing the opposite – and probably taking money out of a fixed income, too.

Our oldest and most frail citizens have given us so much. They deserve much better in return.

"Housecall" with Dr. William B. Ferril
"Dr. Bill"

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