Doctors identify 50 'unnecessary' medical interventions

A list of 50 tests, treatments and procedures 'of questionable value' has been published by the Choosing Wisely UK campaign.

Not all patients with simple respiratory tract infection infections need antibiotics, as highlighted in the new Choosing Wisely recommendations. | iStock.com/Savushkin
Not all patients with simple respiratory tract infection infections need antibiotics, as highlighted in the new Choosing Wisely recommendations. | iStock.com/Savushkin

Doctors behind the Choosing Wisely campaign believe the 50 interventions have little or no value and should be replaced with simpler or more effective alternatives. 

Choosing Wisely, part of a global initiative which started in the US in 2012, was launched in the UK in 2016 by the Academy of Medical Royal Colleges. The campaign aims to engage doctors and patients in making shared decisions about potentially unnecessary and harmful medical interventions. 

In developing the new recommendations, colleges and speciality societies were encouraged to involve patients in selecting the top five treatments or procedures in their field that were of questionable value. 

Some of the recommendations included are:

  • Extending the period the contraceptive pill is routinely prescribed from three or six months to 12 months.
  • Encouraging everyone, not just children and the elderly, to take vitamin D supplements in the winter.
  • Reviewing the use of antibiotics for patients with bacteria in their urine who have no, minimal, non-specific, or long-standing urinary symptoms.

The academy estimates that implementing the recommendations could save the NHS billions of pounds a year. 

Shared-decision making

The campaigners acknowledge that one of the main barriers to tackling the problem of overuse is that doctors are concerned patients will find it difficult to accept fewer interventions. However, they emphasise that informed patients often opt for less intervention, not more.

'The more we learn about medicine, the more we learn about the risks and potential harms too. We have long had a tendency to over-medicalise in this country and it’s a problem that really needs addressing now,' said Prof Dame Sue Bailey, chair of Choosing Wisely UK.

'Too often there’s pressure on both the patient and the doctor to do something, when doing nothing might often be the best course of action. And only when a patient is fully informed about the consequences of what’s being proposed by the doctor should the decision be made about how to proceed,' she added. 

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