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There are a few topics here at Healthcare Triage that just won't seem to go away. Vaccines and autism. Diet and exercise. Survival rates. But the one that trumps them all is supplements. Americans seem obsessed with them.

The one group I thought might not be overtaken by this craze was the elderly. Boy, was I wrong. This is Healthcare Triage News.

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There are a few topics here at Healthcare Triage that just won't seem to go away: vaccines and autism, diet and exercise, survival rates. But, the one that trumps them all is supplements. American's seem obsessed with them. The one group I thought might not be overtaken by this craze was the elderly. Boy, was I wrong! This is Healthcare Triage News.


Changes in Prescription and Over-The-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011.

Researchers wanted to look at how the prevalence of dietary supplements and over-the-counter medication use changed in the elderly from 2005 to 2011. They were especially concerned about how these products might potentially be the cause of major drug-drug interactions.

They conducted a longitudinal, nationally representative cohort study of community-dwelling adults, ages 62 to 85. They interviewed them and directly examined their medications in 2005/6, and then again in 2010/11.

Before I even get into the results, we need to acknowledge some facts. Supplements are huge business in the United States. In 2015, we spent 21 billion dollars on vitamins and herbal supplements. What makes this baffling is that supplements aren't heavily regulated in this country. That means it's entirely possible that what you think you're taking bares no resemblance to what you're actually swallowing. Don't take my word for it; investigations have confirmed that this is not an unlikely thing to happen, and we've covered that in previous episodes.

And, while doctors and electronic medical records regularly screen for prescription medications, we often miss over-the-counter medications, let alone supplements. Many don't consider them when they talk about medications in the clinic or hospital.

In this study, more than 2,000 participants, average age 71 years or so, were interviewed in both time periods. In 2005, 84% used at least one prescription medication, and in 2011, that increased to 88%. The concurrent use of at least five prescription medications increased from 31% to 36%. Over-the-counter medications decreased from 44% to 38%. But, the use of supplements increased from 52% to 64%.

The potential for major drug-drug interactions increased significantly as well. It was about 8% in 2005, increasing to more than 15% in 2011. Most of those new potential problems were due to interactions between medications patients were prescribed and supplements they were taking.

It's bad enough that so many Americans are taking supplements which, one, can be expensive, two, often provide no proven benefit, and, three, may not even be full of what the bottle says they are. What's worse is that many of these supplements may also be increasing the potential for adverse outcomes due to other medications that people are already taking.

Physicians and the health care system need to be aware that even among the elderly, huge numbers of people are taking these substances which might not only be doing them no good, but also might be doing them harm.


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