Choosing Wisely: Five Things for Geriatricians to Question
If you could change one thing about your field, what would it be? Every year, the Choosing Wisely initiative releases their “Five Things Physicians and Patients Should Question” series, which asks healthcare providers and specialists to identify things in their specialty that could be improved. The American Geriatrics Society released their version of this year’s list. This is added to last year’s list of five to make ten total.
One of the big ones for this year is “Don’t prescribe a medication without conducting a drug regimen review.” Geriatric patients are more likely to have multiple conditions and tend to take more medications as a result, which means they’re more at increased risk for adverse effects.
This year’s list is:
- Don’t prescribe cholinesterase inhibitors for dementia without periodic assessment for perceived cognitive benefits and adverse gastrointestinal effects.
- Don’t recommend screening for breast or colorectal cancer, nor prostate cancer (with the PSA test) without considering life expectancy and the risks of testing, overdiagnosis and overtreatment.
- Avoid using prescription appetite stimulants or high-calorie supplements for treatment of anorexia or cachexia in older adults; instead, optimize social supports, provide feeding assistance and clarify patient goals and expectations.
- Don’t prescribe a medication without conducting a drug regimen review.
- Avoid physical restraints to manage behavioral symptoms of hospitalized older adults with delirium.
To learn more about the AGS, please visit www.americangeriatrics.org.