10:47 AM
ari sari
While doctors are medicalizing patients at a rapid rate, especially the elderly, new moves to force E-Prescribing may promote a downturn in the quality of health care as it moves more to rationed and tick box care (knee-jerk, cause/effect, lineal thinking).
Is this yet another call to you, my readers, to make stong efforts now to be more active in your own health care?
GPs are medicalising healthy elderly people, professor warns. Elderly people are being turned into patients by GPs blindly following guidelines to hand out pills for high blood pressure and cholesterol, a professor has said.
by Rebecca Smith, Medical Editor, 03 Mar 2009
The ‘paternalistic society’ and medicine by ‘tick box’ has overtaken personal advice, Michael Oliver, emeritus professor of cardiology at Edinburgh University wrote in the British Medical Journal online.
He said many of the drugs including those for high blood pressure and statins for raised cholesterol have side effects which many elderly people find debilitating.
Prof Oilver wrote: “Nowadays few elderly people are allowed to enjoy being healthy. A bureaucratic demand for documentation can lead to overdiagnosis, overtreatment, and unnecessary anxiety. Preventive action may be irrelevant and even harmful in elderly people. More than 30 years ago, in his book Medical Nemesis, Ivan Illich called this trend “the medicalisation of health.”
He said the GP incentives to diagnose and treat patients, known as the Quality and Outcomes Framework, which means a proportion of the practice income is dependent upon hitting target, has meant many elderly people who considered themselves healthy are being put on pills.
Prof Oliver said: “Many older people, often retired, are summoned by their general practitioner for an annual health check. They may feel reasonably well, but the NHS does not always permit such euphoria. They may be told that they have hypertension or diabetes or high cholesterol concentrations; that they are obese; that they take too little exercise, eat unhealthily, and drink too much.”
He warned that the practice of medicalising the elderly can be harmful and many of the guidelines for treating high blood pressure and cholesterol are based on much younger people or on evidence that the drugs reduce the risk of a heart attack or stroke, but only by a small amount.
He added: “Are those people who have now been turned into patients warned sufficiently about side effects? Are minor side effects, which can be debilitating in this age group, reported to health authorities? More importantly, are doctors willing to discontinue treatment and permit these patients to return to their previously unencumbered and reasonably fit lives?”
David Stout, director of the Primary Care Trust Network at the NHS Confederation, said: “It is important to have procedures in place to ensure a high standard of healthcare for all patients, irrespective of their age. However there is no such thing as ‘one size fits all’ when it comes to healthcare. All GPs treat elderly patients on an individual basis and this should remain the case. Guidelines are exactly that and should not be taken as a binding instruction.”
http://www.telegraph.co.uk/health/healthnews/4932032/GPs-are-medicalising-healthy-elderly-people-professor-warns.html
E-prescribing to soar with new spending By Will Dunham, Mon Mar 16, 2009
WASHINGTON (Reuters) – As many as 75 percent of U.S. doctors will be writing electronic prescriptions within five years, thanks to new federal spending to encourage e-prescribing, according to a forecast released on Monday.
The economic stimulus bill signed by President Barack Obama last month included about $19 billion to promote the use of healthcare information technology, including e-prescribing.
"Broader health IT (information technology) adoption will create a safety revolution in American healthcare," Pharmaceutical Care Management Association President and Chief Executive Officer Mark Merritt said in a telephone interview.
An estimated 13 percent of U.S. doctors prescribe drugs electronically, leaving the vast majority writing paper prescriptions, according to Surescripts, which operates the largest U.S. electronic prescribing network.
The report projected the figure would increase to 75 percent in five years and to about 90 percent by 2018.
The report, prepared by the healthcare research firm Visante for PCMA, projected that e-prescribing would save the U.S. government $22 billion over the next decade, more than covering the $19 billion in spending in the stimulus bill.
Among other things, the savings would come from increased use of cheaper generic drugs and the prevention of medical errors such as patients getting the wrong drug because a pharmacy misreads a doctor's handwriting, the report said.
Greater use of e-prescribing also will prevent 3.5 million medication errors and 585,000 hospitalizations by 2018, the report projected.
Seventy-six percent of U.S. retail pharmacies can handle prescriptions electronically.
The advantages of e-prescribing -- sending a prescription electronically to a pharmacy -- are widely recognized, but the costs of adopting it have dissuaded many doctors.
The drive toward greater use of e-prescribing and electronic medical records is part of Obama's plans for a sweeping overhaul of the U.S. healthcare system.
In addition, Medicare, the federal health insurance program for the elderly and disabled, in January began to offer financial bonuses to doctors who use e-prescribing.
(Editing by Maggie Fox and Eric Walsh)
Copyright © 2009 Reuters Limited
Doctors are too reliant on prescribing drugs for heart disease at the expense of helping their patients to lead healthier lives, a new study suggests.
by Kate Devlin, Medical Correspondent, The Telegraph, UK, 12 Mar 2009
Some patients are receiving too little advice about cutting down on smoking or reducing their weight as doctors increasingly reach for pills to treat them, according to the study, published in the Lancet medical journal.
The report comes just a week after a leading expert warned that millions of elderly patients were being prescribed drugs that they did not need, for conditions ranging from high blood pressure to high cholesterol or diabetes.
Professor Michael Oliver warned that a "tick-box culture" was leading to overtreatment and unnecessary anxiety for many older people.
The latest study looked at the treatment of heart disease across 22 European countries.
It found that one in five people diagnosed with the condition continued to smoke, in spite of the well-known problems that smoking can cause for the heart.
Researchers also found that sufferers were twice as likely to have diabetes as 12 years ago, partly because of the growing problem of obesity.
Only around one in three patients surveyed were referred to programmes designed to prevent heart attacks by focusing on lifestyle changes.
At the same time researchers found that doctors were prescribing greater numbers of drugs.
"The results of the study should be a cause for concern for all health policy makers, physicians and other healthcare professionals," according to its authors, led by Professor David Wood from Imperial College London.
Heart disease is Britain's biggest killer and every six minutes someone dies from a heart attack in this country.
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