The days of prescribing antibiotics for viral illnesses are numbered.
The once-standard procedure is now considered worthless and in some cases harmful to patients, said Dr. Lee Norman, vice president and chief medical officer at the University of Kansas Hospital in Kansas City, Kan.
But that knowledge was gleaned from years of research comparing the antibiotics to other treatments, including letting the body heal itself.
That research is not always done. Or if it is, the results are not always readily available to doctors and other health care providers.
Without that information, experts say, doctors often rely on anecdotal evidence, studies done by companies selling the drugs, or the physicians’ own experience when deciding what to prescribe.
Dr. Rick Kellerman, chairman of the Department of Family and Community Medicine at the University of Kansas School of Medicine in Wichita, said it is daunting for doctors to know what treatments among many are best.
“It’s very confusing,” he said. “You can’t figure out whether one drug is more effective than another which might even cost less. You don’t have the data at the clinical level to use in day-to-day life.”
Sometimes the guidelines derived from comparative effectiveness research require physicians to abandon long-practiced treatments.
“The idea is to pick the right evidence by getting groups together to study it and determine which seems to be the best thing to do,” said Dr. Hewett Goodpasture, vice president for clinical quality and patient safety at Via Christi Regional Medical Center in Wichita. “Then the trick is to get physicians to give up autonomy to do that. Even nurses have to start doing things in a more standardized manner.”
“Some have rejected it as ‘cookbook medicine,’ but that anger is ill-placed,” Norman said. “This is actually what we’ve been keeping with our whole lives, translating the best evidence into the best care that’s the most predictable for a good outcome.”
Expanding comparative effectiveness research would provide more information for doctors and those who pay for health care, said Andy Allison, deputy director of the Kansas Health Policy Authority, which oversees the state’s Medicaid program.
“Let me put it simply: Information is good,” Allison said. “We need information about what works in health care — which procedures work, which work best, which medicines do more good than harm.”
-Sarah Green is a staff writer for KHI News Service which specializes in coverage of health issues facing Kansans. She can be reached at sgreen@khi.org or at 785-233-5443, ext. 123.