- WASHINGTON (Reuters) - U.S.
doctors fail to prescribe the most effective medicines, patients do not
get the right tests and often do not take easy steps to prevent disease,
a report issued on Tuesday shows.
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- U.S. research is the best in the world but is not put
into everyday use, the Institute of Medicine said in a report.
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- "We spend more than $1 trillion on health care annually
... but we repeatedly fail to translate that knowledge and capacity into
clinical practice," said the institute, which advises Congress and
the federal government.
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- For example, 75 percent of adult diabetes patients do
not get routine exams that could prevent limb amputation or death, and
many advanced cancer patients fail to get drugs to ease excruciating pain.
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- "Despite proven guidelines for pain relief, many
suffer needlessly because of health care providers' ignorance of proper
protocols for pain management or biases against the use of opioid medications,"
George Isham, medical director of Minneapolis-based health plan HealthPartners
Inc., who led the panel that wrote the report, told a news conference.
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- The report did not blame doctors, instead saying "systems
of care" such as hospital procedures and health maintenance organization
rules were inadequate.
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- "It's not a bad apple problem," said Janet
Corrigan, an Institute staffer who edited the report. "It's that there
isn't a system."
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- The panel outlined 20 areas most in need of change including:
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- -- Proper treatment of asthma
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- -- Better screening for cancer, major depression, smoking
and obesity
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- -- Improved care for children with special health needs
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- -- Early management of diabetes
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- -- Better care for those at the end of life with advanced
organ system failure, especially congestive heart failure and chronic obstructive
pulmonary disease
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- -- Frailty associated with old age
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- -- Better treatment of high blood pressure
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- -- More widespread immunization of children and adults
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- -- Prevention of heart disease, the No. 1 killer of Americans
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- -- Better management of drug use to prevent medication
errors and overuse of antibiotics
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- -- Prevention and surveillance of infections acquired
in hospital, which kill nearly 90,000 patients a year
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- -- Pain control in advanced cancer
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- -- Better care before and during childbirth
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- -- Severe and persistent mental illness
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- -- Early treatment and rehabilitation of strokes
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- -- Improvement of care coordination
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- -- Self-management and health literacy
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