LTC docs advise against incontinence catheters

AMDA — The Society for Post-Acute and Long-Term Care Medicine (AMDA) is advising long-term caregivers against using indwelling urinary catheters to manage urinary incontinence — one of five common practices or tests that lack scientific evidence to support their use in such settings, physicians say.

The warning was one of five released Friday in conjunction with the ABIM Foundation's Choosing Wisely® campaign. Its goal is “to encourage discussions among physicians, patients, and other healthcare stakeholders about medical tests and procedures that may be unnecessary or even cause harm,” the organization said in a statement. There are 10 practices now on AMDA's list; the original five were issued in September 2013.

The other new practices on AMDA's list advise against:

• Recommending screening for breast, colorectal or prostate cancer if life expectancy is estimated to be less than 10 years

• Obtaining a C. difficile toxin test to confirm “cure” if symptoms have resolved

• Recommending aggressive or hospital-level care for a frail elder without a clear understanding of the individual's goals of care and the possible benefits and burdens

• Initiating antihypertensive treatment in individuals 60 years and older for systolic blood pressure.

“More than 70 specialty societies have joined Choosing Wisely, and many, like AMDA, are expanding on their original lists of overused tests, treatments and procedures clinicians and patients should talk about,” said Daniel Wolfson, executive vice president and chief operating officer of the ABIM Foundation.