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Medical Inertia: Old Drugs Persist Despite Warnings
21 Sep
Summary
- Stopping older, less effective medications can be surprisingly difficult.
- Drug use often declines slowly, if at all, after new research emerges.
- Habit and ingrained practices contribute to persistent medication use.
Medical inertia, the tendency for medications to remain in use despite evidence of reduced effectiveness or increased risk, poses a persistent challenge, especially for older adults. Drugs like benzodiazepines, used for anxiety and insomnia, continue to be prescribed, with usage among those over 75 even rising recently. Prescriptions through long-term care facilities have more than doubled, with many users taking them long-term, increasing dependence risks.
Similarly, antibiotics like fluoroquinolones were once standard for diverticulitis. Despite 2015 guidelines recommending against routine use for uncomplicated cases, antibiotic prescriptions for this condition remain near-universal. This overuse contributes to antimicrobial resistance and potential side effects, while simpler treatments are often effective.
Aspirin for primary cardiac prevention in individuals aged 60 and older has also seen slow adoption of updated guidelines. While use has dropped since 2011, over a third of those aged 70+ still take it, despite evidence of scant benefit and increased bleeding risks. Better strategies now exist for primary prevention.
