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Written By: Editorial Team | Updated : October 6, 2012 10:55 AM IST
Dr Kameshwar Prasad, head of the clinical epidemiology unit at AIIMS said, 'On many occasions, doctors ask for tests that are unnecessary. Similarly, there are drugs that have become outdated or whose efficacy isn't proven. But doctors keep prescribing them. Unless there are standard guidelines on treatment of certain illnesses, such misuse will keep happening.'
AIIMS's neurology department recently screened prescriptions of 250 brain stroke patients referred from different hospitals. According to them more than 48% of the patients were prescribed an unapproved drug. 'Either the doctor did not know about it or he used it despite knowing that it's not effective for the condition. In both cases, the patient had to suffer,' Dr Prasad said.
There is an increase in the number of cases involving unwarranted prescriptions of surgical procedures, diagnostic tests and medication. According to Dr Prasad, before making a decision the patients must ask their doctor about the pros and cons of the treatment offered. He said that unnecessary diagnostic tests and surgical procedures put additional financial burden and also affect the patient's recovery. 'We are also proposing that evidence-based treatment methodologies should be emphasized in medical schools,' he said.
'Every hospital should conduct an audit of various procedures carried out, say in a month. This would give us much-needed data about how prevalent each procedure is, and whether it is being misused,' Dr Prasad said.
A first of its kind international meet will be held by AIIMS to create awareness on the issue, where experts will discuss how standard guidelines can be evolved for treating diseases.
According to a study published in the Journal of the American College of Cardiology, only 36% of patients who had undergone non-emergency angioplasty to clear a clogged artery actually met the criteria for the procedure . 50% of the cases did not have enough evidence to show angioplasty would help and in 14%, the procedure was absolutely not required.
Data from more than 24,000 angioplasty patients at 58 hospitals in New York State between 2009 and 2010 was gathered by the researchers. They measured how well the physicians followed the angioplasty guidelines advised by the American Heart Association and the American College of Cardiology.
The most misused procedures were hysterectomy (uterus removal), caesarean section and angioplasty for artery blockage, experts said. Among drugs, the most commonly misused were vitamins, steroids and antioxidants. In the case of angioplasties, experts said not sufficient time was given to the patients to decide whether they need to go for the procedure or not. A patient with a blocked artery has three lines of treatment open - drug treatment, angioplasty and surgery.
'Vertebroplasty - a spinal procedure where bone cement is injected into fractured vertebra - has proved to be ineffective in many studies. Still, it is being used as a treatment method in patients complaining of backache,' Dr Paul Glaszious, former director of Oxford University's Centre for Evidence-based Medicine said.
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