… the effect of polypharmacy . … Lam JYJ, Barras M, Scott IA, et al. Scoping review of studies evaluating frailty …

Provider and patient underestimation of harms of tests and treatments may lead to over treatment. This article presents seven domains of harm of tests and treatment which warrant comprehensive research: (1) physical impairment, (2) psychological distress, (3) social disruption, (4) disruption in connection to healthcare, (5) labeling, (6) financial impact, and (7) treatment burden. Research is especially important in vulnerable patient populations.

… Ther Adv Drug Saf … Adverse drug events are a common source of harm in both inpatient and ambulatory … 75 studies concluded that cardiovascular medications are a leading cause of medication harm across different clinical …

Overuse or low-value procedures may result in patient physical, psychological, or emotional harm. This study explored the association between eight low-value care procedures and length of stay (LOS) and cost. All eight procedures were associated with increased LOS and cost, particularly spinal fusion. Patients receiving low-value care may be exposed to increased risk of adverse events and hospital-acquired conditions.

Sound critical thinking skills can help clinicians avoid cognitive biases and diagnostic errors. This article describes three critical thinking skills essential to effective clinical care – clinical reasoning, evidence-informed decision-making, and systems thinking – and approaches to develop these skills during clinician training.

Cognitively impaired older adults living in residential aged care facilities (RACF) are at risk of adverse drug events related to potentially inappropriate polypharmacy. Based on telehealth visits with 720 RACF residents, 66% were receiving polypharmacy, with cognitively intact residents receiving significantly more medications than cognitively impaired residents. Overall, 82% of residents were receiving anti-cholinergic medications which should be avoided in this population. Future interventions and research should pay particular attention to the prescribing of these medications.

Overtreatment and overuse of healthcare services have been identified as potential sources of patient harm. Using Medicare fee-for-services claims, this study sought to describe hospital characteristics associated with 12 low-value services. Results showed the highest levels of overuse were associated with nonteaching and for-profit hospitals, particularly in the American South. The authors suggest interventions to decrease overuse and overtreatment could be targeted based on hospital characteristics and region.

… considerations , such as use of unproven therapies. … Scott IA. COVID-19 pandemic and the tension between the need …

… study, researchers found that patients who developed a hospital-acquired condition after undergoing a procedure that most likely should not have been performed … condition. … Badgery-Parker T, Pearson SA, Dunn S, Elshaug AG. Measuring Hospital-Acquired Complications …

… prescribing of potentially inappropriate medications is a quality and safety concern. This narrative review found …

… the effort to improve diagnosis have heralded diagnosis as a team activity . This commentary suggests that specialists … rather than disease-centered care to ensure a wide range of considerations are explored to avoid …

… strategies to mitigate cognitive biases in health care. … Scott IA, Soon J, Elshaug AG, Lindner R. Countering cognitive biases in …

… … JAMA Intern Med … Polypharmacy in older patients is a predictor of medication errors. However, deprescribing—stopping or reducing medicines in a patient's drug regimen—can introduce opportunities for harm if not done appropriately. This commentary presents a protocol to enhance the safety of deprescribing by …

This systematic review examined prescribing of potentially inappropriate medications and found that prescriber characteristics (such as clinical inertia and lack of knowledge) and system characteristics (such as insufficient time to review medications and limited availability of nonmedication treatments) both contributed to persistent prescribing of medications associated with increased risks. These findings emphasize the need for fundamental health care reform in order to improve medication safety.

This study found high levels of physician agreement using an adverse event screening tool for patients admitted with chronic heart failure and pneumonia.

… journal of medicine … Am J Med … This commentary describes a framework to help prevent inappropriate prescribing for …

This commentary analyzes how cognitive errors occur and shares strategies to minimize their incidence and impact.