One of the more depressing parts of being an awake physician in the medical system is reading the drug lists of the patients you see and realizing how many prescriptions they are on that do not benefit them, and in many cases harm them. Presently, 66 percent of U.S. adults are estimated to have at least one prescription and on average, they have nine prescriptions filled per year (which can include renewals of an existing one).

Since doctors are extremely reluctant to terminate existing prescriptions, this creates a scenario where people get placed on more and more drugs as they age (some of which are for treating the side effects of other drugs they are taking).

This situation is even worse for the elderly, who have more time to be put on an increasing number of medications, and due to their altered physiology, are also the most vulnerable to the harmful effects of those medications. For example, from 2009-2016, after two billion office visits were assessed, it was found that for adults over 65, 65.1% were on two or more drugs, 48.9% were on four or more, and 36.8% were on more than five (with the highest use occurring in the oldest Americans).

One of the best illustrations of the problem came from a study that compared 119 disabled elderly adults living in nursing homes to 71 matching controls. These patients (on average, were on 7.09 medications) were screened for which of their medications clearly met the existing criteria for being discontinued (on average 2.8 per patient). After those medications were discontinued in the test group, when compared to the controls who remained on all of their existing prescriptions, it was found that:

•The death rate dropped by 53% (in one year, 45% of the control group died, whereas 21% of the test subjects died).

•The annual rate of hospital referrals dropped by 60.7% (30% of the controls vs. 11.8% of the study).

•Not surprisingly, there were also significant cost savings from withdrawing the unneeded medications.