Are We Headed in the Right Direction?
Many Americans are diagnosed with a chronic disease. In 2005, almost half of adults had one or more chronic disease. This is a frightening thought of where we are as a nation, but what is more frightening to me is how chronic disease is often treated. The underlying cause is rarely addressed but more commonly a myriad of drugs are given to try and force the body into “normal” functioning.
I recently read a study “The Changing Face of Chronic Illness Management in Primary Care: A Qualitative Study of Underlying Influences and Unintended Outcomes” in the Annals of Family Medicine. I encourage everyone to read the full study at the link, but I wanted to discuss some of the findings of the study. It is interesting to note that the study was written by anthropologists, and offers a different viewpoint than most medical studies with a look into the lives of patients. While the study only looks at a small group of doctors and cannot be generalized to all doctors, the trends discussed are still alarming and need to be considered. This post will give an overview of the article and points to be considered with more posts to follow with a more in-depth look at specific points.
To begin with, the researchers, being anthropologists, were not as interested in the specific treatments as the sociocultural aspects of the interactions. However, as the study progressed and they saw the prominence of prescription drugs in treatment they were compelled to look more closely at the use of prescription drugs. The authors bring up the subject of polypharmacy – the use of multiple medications by one patient, commonly considered 5 or more medications. Some possible reasons for the high use of drugs given in the study include lowering diagnostic thresholds for many chronic diseases, incentives for doctors to have patients’ lab values within a certain range, the prescribing cascade (prescribing more drugs to control side effects), and the influence of drug company representatives marketing directly to doctors.
It is sad that the authors note that often drugs were suggested almost to the exclusion of any other treatment options such as lifestyle factors. Some of the grim facts the study opens with include:
- Spending of prescription drugs in the US has risen almost 6 times since 1990
- Estimates are 11% of people in the US take 5 medications or more and that number jumps to 40% for those over the age of 65
- Adverse drug reactions reported by the FDA tripled between 1995 and 2005
- Research indicates that adverse drug reactions are the 4th leading cause of death in the US
- Up to 45% of Americans have at least 1 diagnosed chronic disease
There is definitely a problem with the way chronic disease is typically treated in this country! If you find these statistics alarming as I do, find out how to prevent chronic disease NOT “treat” it. Watch for more posts discussing more specifically the points of the study.
