Last March when the world was locking down for the first time in response to Covid, Joan-Ramon Laporte primarily, with me tagging along, wrote a short piece on polypharmacy as a possible hazard for older people, especially those in residential or care homes.
Everybody was looking for the drug that might provide a miracle cure or get out of jail free card for people with Covid infections.
But if drugs can help, they can also harm. What about the drugs you might be on that could make the problem worse and lead to a death that might not otherwise have happened?
Everybody hears about the crucifix or medal that saved the life of a person shot in the chest – because the survivor tells everyone and the media covers it. We don’t hear from those who die from a bullet diverted from a crucifix or medal.
The article didn’t blame any drug, It listed some reasons why some drug groups could pose problems and called for research to monitor the outcomes in people, especially older people in residential or care homes, some of whom are generally viewed as being on more drugs than is necessary.
The piece was sent to the BMJ, the Lancet, NEJM and other journals. Universally it was returned to us without review. Just turned down flat on the spot.
Given that all these journals and our newspapers and media outlets were stuffed full of Covid material, this was odd.
Just like patients with conditions other than Covid can’t get treated these days and die as a result, it seems articles on other topics don’t get published. But in this case we were on the Covid money.
I tweeted that at a time when you could stick the word Covid on a Dennis the Menace cartoon and be published, it was remarkable that the journals would not take this ‘Modest Proposal’ as Jonathan Swift might have called it.
We finally opted to publish on RxISK
It was well received and led Frank Barat to interview Joan-Ramon
Frank also interviewed me – an interview I’m pleased with maybe too pleased.
Some people were interested.
A group in Sweden got in touch shortly afterwards to say that they had posted data and a position paper on a Swedish Government website supporting what we had said – finding there was in fact a risk from some of the drugs that older people are on.
The document in Swedish is HERE.
The translation is HERE.
After that Paul McKeigue, an epidemiologist from Edinburgh made contact and said he and colleagues had found something similar.
The McKeigue paper has just been published in BMC Medicine. It supports the key points being made nearly a year ago.
Mentioning the McKeigue paper on RxISK is not going to make much of a difference. Its a bit like heading out on a paddle-board toward an incoming Tidal Wave. It’ll be worth it if anyone spots either Joan-Ramon or me waving from the top of the Tidal Wave – and perhaps wonders what kind of idiot would head out on a paddle board in conditions like this.
Maybe Dennis should have asked –
Is it better to stay Young and never know Better?
Covid is an instance of Disaster Medicine – a chance to get more people on more stuff whether drugs or vaccines. Not a time to choose wisely.