Thursday, 21 Nov 2019

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Physicians Still Over-Prescribe Antibiotics, Narcotics and Opioids

A study by the American College of Physicians (ACP) found that physicians continue to prescribe treatments that offer little benefit to patients, despite the advice of clinical guidelines. Overuse of antibiotics, aggressive non-palliative treatment in patients with limited life expectancy, treatment of chronic pain, and dietary supplements may be the most frequently used low value treatment interventions used by doctors.

The study is based on a random survey of 5,000 ACP member physicians asking them to identify two treatments frequently used by internists but unlikely to provide High Value Care to patients. The findings are published in Annals of Internal Medicine.

“While many current clinical guidelines recommend appropriate care, the results of this survey may reflect intrinsic motivations to err on the side of treatment rather than ‘doing nothing,’” said lead author Amir Qaseem, MD, FACP, PhD, Vice President, Clinical Policy, ACP, and Chair of ACP’s High Value Care Task Force. “However, as health care shifts to a value driven system, this study shows that doctors are willing to critically assess their own clinical practice.”

ACP's High Value Care recommendations help doctors and patients understand the benefits, harms, and costs of tests and treatment options for diseases so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices. Value is not merely cost. Some expensive tests and treatments have high value because they provide high benefit and low harm. Conversely, some inexpensive tests or treatments have low value because they do not provide enough benefit to justify even their low costs and might even be harmful.

Earlier this year, ACP and the Centers for Disease Control and Prevention issued advice for prescribing antibiotics for acute respiratory tract infections in adults. ACP also has High Value Care and Best Practice Advice for breast cancer screening, cardiac screening, cervical cancer screening, colorectal cancer screening, end-of-life care communication, upper endoscopy for gastroesophageal reflux, generic medications, inpatient glycemic control, hematuria, ovarian cancer screening, prostate cancer screening, and evaluation of patients with suspected pulmonary embolism.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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