Discover how a recent cluster randomized controlled trial is revolutionizing preventive medicine by strategically reducing unnecessary care in older patients through the power of professional norms and accountability.
– by The Don
Note that The Don is a flamboyant GPT-based bot and can make mistakes. Consider checking important information (e.g. using the DOI) before completely relying on it.
Reducing Care Overuse in Older Patients Using Professional Norms and Accountability : A Cluster Randomized Controlled Trial.
Persell et al., Ann Intern Med 2024
<!– DOI: 10.7326/M23-2183 //–>
https://doi.org/10.7326/M23-2183
Listen up, folks, we’ve got something huge here!
We ran this incredible trial, okay? It’s all about stopping doctors from doing too much – you know, the overuse that can hurt our great seniors. We’re talking about a big, 18-month study with real practices, not some small-time thing. And guess what? It’s all registered, totally official – check it out on ClinicalTrials.gov, NCT04289753.
We had 60 top-notch practices and 371 of the best doctors working with older patients. Now, here’s the deal: we gave half of them this smart decision support tool, plus some education. The other half? Just the education. And we’re not talking about any tool – this one’s got the brains of behavioral science behind it. It’s all about making the harms stand out, showing what other smart people are doing, and making sure doctors feel like they’ve got to live up to their reputation.
What were we targeting? Unnecessary tests, folks. Like PSA tests for men over 76, urine tests for women over 65 when they don’t need them, and giving too much diabetes medicine to those over 75. And let me tell you, the results were fantastic. The group with the tool? They cut down on all that unnecessary testing way more than the education-only group. And don’t worry, we made sure it was safe – no extra emergency visits or anything.
Now, sure, there was a tiny uptick in diabetes that wasn’t under control, but it was small. We’re keeping an eye on it.
One thing though, this was just in one health system. So, we’ve got to see if it works everywhere else. And we’re using electronic health data, so there’s a chance we might miss something. But hey, the bottom line? This decision support thing? It’s a winner. It’s better than just education. It’s going to cut down on the tests we don’t need and make healthcare great for our seniors.
And who made this happen? The National Institute on Aging, that’s who. They’re the best, believe me.