Where are all the oldies going?

OK! I’ve had enough. I can’t sit back any longer and watch geriatric medicine become a cash cow for disinterested GPs and uncaring pharmacists.
Let me give you a list:

  • Proton pump inhibitors prescribed and dispensed for years at a time, in high doses, given at the wrong times of the day.

  • Non-steroidal anti-inflammatories prescribed and dispensed for years, often in combination with anti-hypertensive drugs and asthma inhalers.

  • High dose, long-term paracetamol, dispensed to oldies who tell me that they find no difference in their pain threshold. They take them because the doctor says so, and the pharmacist agrees. But they don’t make any difference.

  • Constant changes to generic brands of prescribed medicines, causing confusion, risky outcomes and sometimes a resignation that it’s all too hard to understand anyway so I won’t take them.

  • Supply of stuff that’s deemed to be the “same”, often “switched” to a brand with a better margin, better advertising, prettier rep, or going out of date. There’s no such thing as a generic herb, all salines are not the same, and probiotics play different roles in gut health.

As Gough said years ago……..”it’s time”………

It’s time to make another list:

  • I will intervene in PPI treatment, having understood the nutrient deficiencies and health ramifications involved in this type of drug therapy.

  • I’ll offer clinically proven, evidence-based options to those whom I deem to be at risk

  • I’ll confidently supply the prescriber with any written information I see appropriate to support my recommendations.

  • I’ll try and stick to the same prescription generic brand, every time, to reduce the inevitable confusion cause by “switching”.

  • I’ll listen to what my patient asks for, supplying what they seek, instead of selling them what I want them to buy instead.

  • I’ll keep up to date with the research, especially in complementary medicines, because my patients might know better.

What this “might” mean is that we become important to our patients once again, because at the moment, I’m not too sure how important we are, in spite of the passionate defence by our regulatory bodies that we do have a role to play.

In my clinic work, I ask my patients for the name of the pharmacist who cares for them. Mostly they don’t know………..they know the pharmacy that they visit more frequently, the address, and sometimes the marketing group to which the pharmacy belongs. But they don’t know the pharmacist’s name!

They know their doctor’s name and that’s the end of the health connection. We need to rediscover our professional heritage.

Nutrient deficiencies are a real part of our health role. The outcomes of nutritional deficiencies are dire, especially in the ready acceptance of PPIs

When are we going to be grown-up enough to be proactive, assertive, knowledgeable and most importantly, caring, towards our geriatric market, who seek nothing more that a life with reduced inflammation and pain, happiness and trust in their health providers?
Do you think that it’s time?

3 responses to “Where are all the oldies going?”

  1. I agree Gerald. As a consultant pharmacist I see inappropriate prescribing continued for years and the excuse given is “oh they are stable on that regime so I don’t want to change anything”. Quality of life is so important for our elderly, often more so than quantity. Even if they have been on something for years it is good to review and remember that what was started when they were in their 50’s or 60’s or 70’s may not be appropriate now they are in their 80’s or 90’s. However I also do not like to see them swallowing heaps of supplements which are expensive to buy and often of questionable value. Minimal medication focusing on quality of life is the way to go in my opinion.

  2. Yes It is time!
    It is time to put the interaction before the transaction.
    It is time to put people’s health before the “cheaper brand”.
    I admire your work Gerald, because it is time we support pharmacists to dig deep and remember why they wanted to be a pharmacist? Mainly to support people’s lives and rarely for the money.
    What was the most trusted profession has significantly dropped simply because many pharmacies are placing their own interests before the communities.
    Finally, in a study I conducted with 133 pharmacy members I noticed that many pharmacy assistants usually in their teens or twenties found the elderly customers a pain to work with, they did not have the patience or the training to listen and understand their needs, this lead to frustration from both sides and a lack of care for the elderly.
    It really is time to bring back the community to pharmacy.
    Thanks Gerald.

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