The American Medical Directors Association has joined with ABIM Foundation’s Choosing Wisely® campaign to promote discussions between healthcare providers and patients for what medical tests or procedures may be unnecessary.
There are five practices common in the long-term care setting that may be questionable, AMDA said. Recommendations include:
- Don’t insert percutaneous feeding tubes in individuals with advanced dementia. Instead, offer oral assisted feedings.
- Don’t use Sliding Scale Insulin for long-term diabetes management for individuals residing in the nursing home.
- Don’t obtain a urine culture unless there are clear signs and symptoms that localize to the urinary tract.
- Don’t prescribe antipsychotic medications for behavioral psychological symptoms of dementia in individuals with dementia without an assessment for an underlying cause of the behavior.
- Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.
“By partnering in the Choosing Wisely campaign, our hope is that physicians and patients will talk about the necessity of these tests and procedures, and the quality of patient care will improve,” said AMDA Executive Director Christopher Laxton, CAE. “We believe that the conversations that occur as a result of this campaign will encourage open communication between physicians and patients, families, and others. This, in turn, will promote and support the high-quality, cost-effective, person-centered care that AMDA and our members advocate for on a daily basis.”