The National Summit on Overuse based in Chicago, Illinois, enumerated 5 overused treatments that can harm patient safety and quality.
The goals of the summit were to reduce risks to patients, improve care and discourage waste of patient and hospital resources.
Dr. Richard Hellman, vice chair of the Physician Consortium for Performance Improvement (PCPI) says, “There is increasing evidence that these treatments are unnecessary, expensive and can be harmful.”
What are these 5 overused treatments?
1. Antibiotic use for the common cold
The common cold is most often due to a virus.
Antibiotics or anti-bacterials are medications to treat bacterial infection. Therefore, why give anti-bacterials when the infection is not due to a bacteria?
Frequent and unnecessary intake of antibiotics leads to drug resistance, cumulative overexposure, allergic reactions, stomach upset and depressed immune system.
Physicians may often feel the need to prescribe medications to make the patient feel that something is being done for them. When in truth, the best treatment for the common cold is just drink of plenty of water and bed rest.
2. Blood transfusions
Despite the modern methods of screening donated blood, there are still cases of infection and allergic reaction due to transfusion.
Physicians ought to avoid transfusion as much as possible.
Anemia or low red blood cell count does not mean the need blood transfusion right away.
As long as the patient is ambulant with stable blood pressure and heart rate, high-dose oral iron tablets and control of the menstrual flow may be the initial choice of management.
Even during surgery, there is a growing array of alternative treatments to replace blood loss aside from transfusion. These include oxygen therapeutics and volume expanders.
If the surgeon is anticipating major blood loss and there is time to prepare, why not do autologous blood transfusion or donate your own blood 3 to 5 weeks before your surgery?
Your own blood is the safest you can receive.
3. Ear tubes for children
Tympanostomy involves punching a plastic tube through a child’s eardrum to drain the pus of middle ear infection. This is the most common procedure performed on children in the US.
Middle ear infection can be prevented by simply immunizing the children with pneumococcal vaccine.
4. Early scheduled births
The ideal time to deliver is between 38-40 weeks.
Usually, medications are used to help expectant woman to start having labor pains.
In our culture, early scheduled births are frequently due to a patient’s request especially when the family prefers a particular date of birth.
But, forcing the baby to come out prior to 38 weeks may lead to complications such as prematurity and admission to expensive neonatal intensive care units. Failure to induce an unwilling or unprepared uterus also often ends up in a cesarean section.
Only when the mother or the infant’s health is at risk should a delivery be scheduled before 38-40 weeks.
5. Heart vessel stents
Percutaneous coronary interventions (PCIs) involve putting a tube in a patient’s heart blood vessels through angioplasty.
The summit identified overuse in elective, scheduled PCIs but not in emergency PCIs, where putting a stent could save the life of a patient.
When PCIs were introduced more than 20 years ago, physicians and patients thought the procedure was the key to prolonging their life. But experience and research has shown that not all heart problems can be solved by a stent.
In the U.S. stents are overused either for financial gains or because of “knee-jerk reactions” from cardiologists who have not updated their practice, said Robert O. Bonow, professor of cardiology at Northwestern University Feinberg School of Medicine in Chicago.