Comparative effectiveness studies may not be accepted by patients

Comparative effectiveness is a buzzword that health reformers have been using to help curb soaring medical costs.

And it makes sense. After all, why do we need to subject patients to tests and treatments that haven’t been shown to work? Some degree of standardization of medical care is necessary.

But what if patients don’t listen?

I have mentioned several times that there is a prevailing, and false, mentality among the public that more medicine always means better care. Studies have shown that more intensive health care can lead to complications, unnecessary tests, and potentially worse patient outcomes.

But for comparative effectiveness data to change practice, patients have to buy in. And, in a recent blog post from NPR’s Shots, a patient survey isn’t promising.

In 2006, researcher David Nieman found that endurance racers – a group that’s collectively addicted to ibuprofen – saw no benefit from the over-the-counter pills during the 100-mile Western States Endurance Run, he presented his findings to participants in the next year’s race. And, contrary to their beliefs, the anti-inflammatory drug actually increased swelling for this group, he told them. Would they stop using it? “No,” was the answer.

Changing medical practice and disrupting conventional wisdom is hard — for both doctors and patients. Witness the public outrage when the USPSTF modified their breast cancer screening recommendations last year.

I wrote in USA Today that comparative effectiveness data is necessary to help doctors make the best decisions. Doctors need to buy in.

And so do patients.

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