NEW YORK—The American Geriatrics Society (AGS) released its list of “Five Things Physicians and Patients Should Question,” as part of the American Board of Internal Medicine (ABIM) Foundation’s national Choosing Wisely® campaign. Choosing Wisely aims to spark conversations between physicians and patients about utilizing the most appropriate tests and treatments and avoiding care that may provide no benefit or may cause harm, resulting in unnecessary healthcare costs. The AGS is pleased to join the ABIM Foundation, 25 other medical societies, Consumer Reports, and many other stakeholders in support of Choosing Wisely.
The AGS convened a “Choosing Wisely Workgroup,” which reviewed current medical research and surveyed over 6,000 AGS members and other experts, to determine what potentially unnecessary or harmful treatments are most often recommended to older patients. After deliberations with experts in geriatrics and related specialties, and through a final review process with its committees and leaders, the AGS identified the following five recommendations:
- Don’t recommend percutaneous feeding tubes in patients with advanced dementia; instead, offer assisted oral feeding.
- Don’t use antipsychotics as the first choice to treat behavioral and psychological symptoms of dementia.
- Avoid using medication to achieve hemoglobin A1c <7.5% in most adults 65 and older; moderate control is generally better.
- Don’t use benzodiazepines or other sedative-hypnotics in older adults as the first choice for insomnia, agitation, or delirium.
- Don’t use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present.
“Due to age-related physical changes, many older adults respond differently to medications and other interventions than younger people. And because older people—particularly those with multiple, chronic conditions—are underrepresented in clinical trials, judging the appropriateness and risks and benefits of treatments can be more difficult for clinicians, older adults and their caregivers,” said Paul Mulhausen, MD, vice-chair of the AGS’ Clinical Practice and Models of Care Committee and chair of AGS’ Choosing Wisely Workgroup.
As part of the Choosing Wisely campaign, the AGS and the AGS Foundation for Health in Aging have published a compendium of professional and public resources about the society’s “Five Things,” which can be found at americangeriatrics.org and healthinaging.org.
“Our involvement in Choosing Wisely complements other recent AGS initiatives to improve appropriate prescribing for older patients, and to enhance the overall quality of care for the more than 50% of people over 65 who have multiple, chronic health problems,” said AGS President, James T. Pacala, MD, MS. “Choosing Wisely is an excellent step forward in supporting conversations between healthcare providers and patients about the safest and most cost-effective approaches to care.”
To learn more about the AGS’ “List of Five Things” and other AGS initiatives aimed at improving quality care for seniors, please contact Jillian Akavan at 212-308-1414 or firstname.lastname@example.org.
About the American Geriatrics Society
The American Geriatrics Society (AGS) is a not-for-profit organization of over 6,000 health professionals devoted to improving the health, independence, and quality of life of all older people. The Society provides leadership to healthcare professionals, policy makers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy.
About the ABIM Foundation
The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, read our blog blog.abimfoundation.org, connect with us on Facebook or follow us on Twitter.
About Choosing Wisely®
First announced in December 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation and Consumer Reports to share the lists widely with their members and convene discussions about the physician’s role in helping patients make wise choices. Learn more at www.ChoosingWisely.org.