Introduction to study design and research methods

Description

New approaches to reduce overtreatment
Applications are sought for research to evaluate novel approaches to identify and reduce
overtreatment. Studies should focus on the potential clinical benefit to patients, such as disease specific
outcomes or reducing treatment-related morbidity without compromising efficacy.
Overtreatment is considered to be the continuation of treatment for which diagnosis is “correct”
but where the treatment has an uncertain probability of benefitting an individual patient further or
may even be harmful. It occurs in treatment for both chronic and acute conditions. Overtreatment
includes:
 Treatment of a condition that would resolve itself or not cause symptoms.
 Over-use of antibiotics in response to respiratory infections is associated with development
of antibiotic resistance. Strategies to reduce inappropriate prescribing such as delaying
prescription of antibiotics where it is judged safe to do so may reduce drug-related adverse
events, prescribing costs and antibiotic resistance.
 Overly intensive treatment regimens. Antihypertensive medications are associated with
adverse events including falls. The net benefits of antihypertensive medications are likely to
be different from the general population in people who are frail, or with life-limiting
conditions.
 Polypharmacy. Prescription of multiple medications can cause unintentional interactions; it
may be difficult for patients to take them correctly; some medicines are being prescribed to
treat the side effects of other medicines where alternative solutions are available to reduce
the number of medicines prescribed.
Areas of specific interest include, but are not limited to:
 Evaluating the accuracy of interventions (tools or tests) to identify individuals who may
benefit from de-intensification of treatment.
 Novel interventions to improve or facilitate de-escalation or withdrawal of treatments.
 Evaluating the safety and effectiveness of withdrawing treatments associated with
increased risks at particular time points, for example leading up to surgery or during
pregnancy.
 Reducing treatment burden associated with polypharmacy.