UK doctors urged to curb overtreatment
pharmafile | May 13, 2015 | News story | Sales and Marketing | Academy of Medical Royal Colleges, BMJ, NHS, uk doctors
The UK’s body of medical colleges has launched a new campaign to warn of the dangers of over-treating patients with drugs.
The ‘Choosing Wisely’ campaign is being spearheaded by the Academy of Medical Royal Colleges in partnership with other clinical, patient and healthcare organisations. It aims to discourage doctors from what they see as costly use of medicines that have little evidence of benefit and or are excessive compared to alternative treatments.
Writing in the BMJ, the campaigners note: “A culture of ‘more is better’, where the onus is on doctors to ‘do something’ at each consultation, has bred unbalanced decision making. This has resulted in patients sometimes being offered treatments that have only minor benefit and minimal evidence despite the potential for substantial harm and expense.
“This culture threatens the sustainability of high quality healthcare and stems from defensive medicine, patient pressures, biased reporting in medical journals, commercial conflicts of interest, and a lack of understanding of health statistics and risk.”
The campaign is based on a similar programme in the US and Canada, also named Choosing Wisely, which asks participating medical organisations to work on ‘top five’ lists of treatments with questionable value. So far over 60 specialist societies have joined the campaign in the US and several other countries – including Australia, Japan, and several European countries – have adopted the scheme.
The UK campaign will also compile lists of unnecessary drugs. The organisations will then work to disseminate this information and promote conversations between clinicians and physician, with the aim of helping doctors and patients understand that minor potential benefits may not outweigh potential harm both financial and medical, and that doing nothing is sometimes the best option.
The campaigners partly blame NHS England’s system of payment by results, “which in reality is often a payment by activity”, for overtreatment, as well as the demands of fulfilling the Quality and Outcomes Framework (QOF).
They add: “Decisions need to be made with reference to individual patient circumstances, the wishes of the patient, clinical expertise, and available resources.”
However, in the BMJ article they concede that there is currently no evidence from the US and Canadian campaign that lists of unnecessary drugs reduce usage of such treatments, and that the campaign has yet to reach widespread awareness among medical professionals in the countries.
“Support from the media and medical publications will be vital because the public education campaign is crucial to the programme’s success.
“The academy will ensure that the programme is thoughtfully implemented and rigorously evaluated by demonstrating a reduction in wasteful practices within a fixed time scale.”
George Underwood
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