Patients should be questioning more of their doctors’ treatment decisions, particularly over the potential for negative after effects and alternatives, according to new guidance for the UK’s 220,000 medics.
The Academy of Medical Royal Colleges has called on both patients and doctors to adopt the “Bran test”, weighing the benefits and risks of recommended treatment, as well as the options, and effects of doing nothing.
Representing the 24 colleges and faculties which train and accredit UK doctors, it says this change among other guidelines could help tackle excessive medication use and treatment of little value.
This could help patients say no to extra medications which may provide small health benefits but negatively impact their life in other ways.
Its Choosing Wisely scheme, backed by patient group Healthwatch, mentions more than 50 further tests, treatments and procedures which may have little value, or could be replaced with a simpler alternative.
The programme advocates encouraging everyone to take vitamin D supplements in the winter rather than just the frail and the elderly, extending the period the contraceptive pill is prescribed for women to reduce visits to the GP, and not using drug treatments to manage behavioural and psychological problems in patients with dementia if they can be avoided.
It suggests doctors should talk to relatives and carers before diagnosing dementia rather than just relying on a basic cognitive test, while they should discuss with patients and their family about using antibiotics at the end of life.
The list adds to a previous campaign launched in 2015 which set out the first wave of 40 tests, treatments and procedures deemed to have little or no value.
Professor Dame Sue Bailey, who leads the Academy’s Choosing Wisely campaign, said: “This is all about enfranchising patients and giving them a sense of ownership of the way they are treated.
“Too often patients just accept what a doctor is telling them without question. We want to change that dynamic and make sure the decision about what treatment is taken up is only made when the patient is fully informed of all the consequences.
“Too often there’s pressure on both the patient and the doctor to do something when doing nothing might often be the best course of action.”
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