Abstract
The concepts of overdiagnosis and overtreatment are now emerging more often in the medical literature as awareness of their implications for psychosocial burden and unsustainable cost become clearer. Researchers now have more tools to investigate these widespread low-value care practices in hospitals, primary care and residential aged care.
There are an increasing number of treatment options available to people with little evidence on whether choice of treatment helps. Recent advances in randomised control trial design now incorporate patient preferences for treatment allowing policy makers to better understand whether choice is beneficial or harmful. Ideally this will lead to informed decision making for treatments, including introducing conversations around whether treatment is beneficial at all.
One example where preference is important and where over treatment can occur is with people near the end of life. Older people with progressive, irreversible illness use acute hospitals services, tests, and multiple medications in the last year of life at rates that are questionable given the expected low benefit. This overuse of treatments inflicts unnecessary patient suffering, creates false hope of patient survival and frustration among clinical staff, and generates unsustainable costs. Tools for predicting people at risk of death within the year are available for free but underused. Timely honest conversations on non- aggressive options including supportive care are not occurring. We argue that
public awareness and professional training can reduce this resource waste while improving quality end-of-life.
There are an increasing number of treatment options available to people with little evidence on whether choice of treatment helps. Recent advances in randomised control trial design now incorporate patient preferences for treatment allowing policy makers to better understand whether choice is beneficial or harmful. Ideally this will lead to informed decision making for treatments, including introducing conversations around whether treatment is beneficial at all.
One example where preference is important and where over treatment can occur is with people near the end of life. Older people with progressive, irreversible illness use acute hospitals services, tests, and multiple medications in the last year of life at rates that are questionable given the expected low benefit. This overuse of treatments inflicts unnecessary patient suffering, creates false hope of patient survival and frustration among clinical staff, and generates unsustainable costs. Tools for predicting people at risk of death within the year are available for free but underused. Timely honest conversations on non- aggressive options including supportive care are not occurring. We argue that
public awareness and professional training can reduce this resource waste while improving quality end-of-life.
Original language | English |
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Publication status | Unpublished - 2019 |
Event | 11th Health Services and Policy Research Conference - Auckland, New Zealand Duration: 4 Dec 2019 → 6 Dec 2019 Conference number: 11th http://www.healthservicesconference.com.au/hsraanz2019/ |
Conference
Conference | 11th Health Services and Policy Research Conference |
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Abbreviated title | HSRAANZ |
Country/Territory | New Zealand |
City | Auckland |
Period | 4/12/19 → 6/12/19 |
Internet address |