The “New Old Age: Caring and Coping” blog of the New York Times has been covering the “Choosing Wisely” campaign. This campaign is an attempt to provide laypeople and doctors with a list of tests to avoid. Each medical specialty has been asked to develop a list of “Five Things Physicians and Patients Should Question.” Lists from the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine were published last week on the “Choosing Wisely” website (choosingwisely.org).
AMERICAN GERIATRICS SOCIETY LIST
Here’s the American Geriatrics Society list: (see the webpage for a few more sentences on each item)
www.choosingwisely.org/doctor-patient-lists/american-geriatrics-society/
1. Don’t recommend percutaneous feeding tubes in patients with
advanced dementia; instead offer oral assisted feeding.
2. Don’t use antipsychotics as first choice to treat behavioral and
psychological symptoms of dementia.
3. Avoid using medications to achieve hemoglobin A1c <7.5% in most adults age 65 and older; moderate control is generally better.
4. Don’t use benzodiazepines or other sedative-hypnotics in older
adults as first choice for insomnia, agitation or delirium.
5. Don’t use antimicrobials to treat bacteriuria in older adults
unless specific urinary tract symptoms are present.
AMERICAN ACADEMY OF HOSPICE AND PALLIATIVE MEDICINE
1. Don’t recommend percutaneous feeding tubes in patients with
advanced dementia; instead, offer oral assisted feeding.
2. Don’t delay palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment.
3. Don’t leave an implantable cardioverter-defibrillator (ICD)
activated when it is inconsistent with the patient/family goals of
care.
4. Don’t recommend more than a single fraction of palliative
radiation for an uncomplicated painful bone metastasis.
5. Don’t use topical lorazepam (Ativan), diphenhydramine (Benadryl), haloperidol (Haldol) (“ABH”) gel for nausea.
And here’s a link to the “New Old Age: Caring and Coping” blog post about these two lists:
newoldage.blogs.nytimes.com/2013/02/28/for-the-elderly-lists-of-tests-to-avoid/
The New Old Age: Caring and Coping
Health Care
For the Elderly, Lists of Tests to Avoid
New York Times
By Paula Span
February 28, 2013, 6:54 am
Robin