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[How to avoid overmedicalization of the elderly patient ?]
F Benoît1, K Segers2, C Sergeant1
1Clinique de Gériatrie, CHU Brugmann, ULB.
Revue Medicale De Bruxelles
|October 16, 2018
Summary
Over-medicalization, including over-diagnosis and over-treatment, affects elderly patients. Evidence-Based Medicine struggles to prevent this, leading to potential harm from misdiagnoses and unnecessary treatments.
Area of Science:
- Geriatrics
- Medical Ethics
- Health Policy
Background:
- Over-medicalization, encompassing over-diagnosis and over-treatment, is a growing concern, particularly for elderly patients.
- Awareness of over-medicalization has increased since the first "Preventing Overdiagnosis" conference in 2013.
- Current Evidence-Based Medicine (EBM) practices do not adequately prevent over-diagnosis.
Purpose of the Study:
- To explore the multifaceted issue of over-medicalization in the elderly.
- To identify factors contributing to over-diagnosis and over-treatment in geriatric patients.
- To discuss strategies for preventing over-medicalization in clinical practice.
Main Methods:
- Review of existing literature on over-medicalization and geriatric care.
- Analysis of how geriatric-specific factors influence diagnostic and treatment decisions.
- Discussion of case examples illustrating diagnostic pitfalls.
Main Results:
- Geriatric characteristics like multiple comorbidities, polypharmacy, and frailty increase the risk of misdiagnosis.
- Interpretation of biological and para-clinical data can lead to unnecessary treatments, as seen in subclinical hypothyroidism and Alzheimer's disease.
- Evidence-Based Medicine (EBM) may not sufficiently address the complexities of diagnosing and treating elderly patients, potentially leading to over-medicalization.
Conclusions:
- Over-medicalization poses significant risks to elderly patients, including misdiagnosis and harmful treatments.
- Specific geriatric vulnerabilities necessitate careful interpretation of medical data to avoid unnecessary interventions.
- Further research and revised clinical guidelines are needed to effectively prevent over-medicalization in the elderly population.
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