40 common treatments are of little or no use, say doctors

Chemo, back X-rays and prostate tests often unnecessary, UK medical body has advised

Using tap water to clean up cuts and grazes is just as good as a saline solution, and a plaster cast is not needed for some small wrist fractures in children because a removable splint will help them to heal just as quickly.

These are among dozens of common treatments for a range of ailments deemed to be of little or no use, senior doctors in Britain have said as part of the UK’s Choosing Wisely campaign.

To help patients and medics make the right decisions about care, the British Academy of Medical Royal Colleges has recorded 40 treatments or tests with this in mind, along with the gentle warning that “more doesn’t always mean better”.

Lower back pain, prostate condition and terminal cancer are among the wide-ranging ailments listed upon in this first wave of recommendations.

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The statement comes after 82 per cent of doctors said in a 2015 study that they had prescribed or carried out a treatment that they knew to be unnecessary. Patient pressure or expectations were given as the main reason, the academy noted.

The academy’s global campaign aims to cut down on over-medicalisation and help provide the groundwork for a fully informed conversation about the risks and benefits of treatments and procedures.

The academy also gives key pointers to patients and doctors on treating health-related issues. Patients should ask about the risks or downsides, the possible side effects, if there simpler or safer options, and “what will happen if I do nothing”.

Chemo and cancer

The advice notes that chemotherapy may be used to relieve terminal cancer symptoms but can also be painful, cannot cure the disease, and may well bring further distress in the final months of life.

“It is vital patients are as well-informed as possible to help them make decisions around their treatment,” said Adrienne Betteley of the UK’s Macmillan Cancer Support.

“Chemotherapy is a crucial part of cancer treatment, having had an enormous impact on rising survival rates over the years,” she added. “However, it can result in severe side effects. Therefore it’s important that health care professionals consider the full impact when delivering something so powerful.”

Ms Betteley said cancer patients should be told about potential side effects, be offered a care plan, be told where to get support, and know who to speak to about their worries and fears.

“The NHS needs to be equipped to provide this for cancer patients in order to cope with the increasing numbers of people being diagnosed and living with the disease,” she said.

Healthcare resources

Dame Sue Bailey, chairwoman of the academy, said: “We all have a duty to look after resources in healthcare, especially when the NHS is under so much pressure, but that’s not the main motivation for this initiative.

“What’s much more important,” Prof Bailey added, “is that both doctors and patients really question whether the particular treatment is really necessary. Medicine or surgical interventions don’t need to be the only solution offered by a doctor, and more certainly doesn’t always mean better”.

The advice includes:

1. Tap water is just as good for cleaning cuts and grazes as saline solution.

2. Small wrist fractures in children do not normally need a plaster cast, and will heal just as quickly with a removable splint.

3. Children with bronchiolitis or breathing problems usually get better without treatment.

4. Electronic monitoring of a baby’s heart is only needed during labour if the mother has a higher-than-normal risk of complications.

5. Chemotherapy may be used to relieve symptoms of terminal cancer but it cannot cure the disease, and may well bring further distress in the final months of life

6. Routine screening for prostate conditions using a test known as a prostate specific antigen, or PSA test, does not lead to longer life and can bring unnecessary anxiety.

– (Press Association)