Wednesday, April 17, 2013
Physicians identify 90 overused tests, treatments
National groups representing 17 medical specialties have joined a campaign to raise awareness about commonly ordered tests and treatments that aren't always necessary and could cause undue harm.
Using the latest evidence about management and treatment options, the physician groups each released a list of five tests, procedures and medication therapies in their specialties that they believe should be carefully considered before ordering. The lists are part of the ABIM Foundation's Choosing Wisely® campaign, which now includes 25 national medical specialty societies that have identified a total of 130 such tests and procedures.
"Through these lists of tests and procedures, we hope to encourage conversations between physicians and patients about what care they truly need," ABIM Foundation President and CEO Christine K. Cassel, MD, said in a news release.
The evidence-based recommendations made by these physician experts include:
- Children with minor head injuries should not automatically receive a CT scan.
- Women 30–65 years old of average risk should not receive routine annual Pap tests.
- Asymptomatic patients who have a low risk for coronary disease generally should not receive stress tests using echocardiographic images to assess their cardiovascular risk.
Visit the Choosing Wisely website to learn more about the initiative and view the lists of physician recommendations.
Education key to curtailing prescription opioid misuse
An open letter issued by the U.S. Food and Drug Administration (FDA) calls on physicians who prescribe opioid pain medications to make sure they are fully educated about these drugs, including the updated drug labels for each product they prescribe.
The agency says prescribers are critical to addressing the epidemic of opioid misuse, abuse and diversion.
"[The] FDA is extremely concerned about the inappropriate use of opioids, which has reached epidemic proportions in the United States, becoming a major public health challenge," FDA Commissioner Margaret A. Hamburg, MD, said in a blog post. "Our nation's front-line health care professionals, especially physicians and other prescribers, can play an important role in efforts to reduce this trend."
The agency's open letter outlines three actions physicians can take toward this end:
- Complete training in appropriate opioid prescribing practices. The FDA also announced that the first training program tied to the agency's Risk Evaluation and Mitigation Strategy is now available. This and future programs will offer continuing medical education credit.
- Know the content of the latest opioid drug labels. Drug manufacturers are now required to follow revised guidelines for opioid drug labels, making the labeling more consistent across opioid medications and increasing the prominence of information about risks and precautions. The letter includes examples of key label information.
- Educate patients about the drugs. Such discussions should cover appropriate use, potential risks and proper disposal techniques, the agency said. The letter provides links to education materials physicians can share with their patients.
In addition, it is important for children and adults to understand that they should not take drugs prescribed to someone else.
Physicians can help keep prescription drugs out of the hands of people for whom they were not prescribed by encouraging their patients to safely dispose of unused medications. The next National Prescription Drug Take-Back Day, hosted by the Drug Enforcement Administration, will take place at 10 a.m.–2 p.m. April 27 at sites around the country. Visit the DEA website to look up a local collection site.
The AMA also is working toward reducing the misuse, abuse and diversion of prescription drugs through federal legislation, state strategies and FDA efforts. Visit the AMA's Web page on combating prescription drug abuse and diversion to learn more.