Hospital introduces
‘Choosing Wisely’ initiative
PRESQUE ISLE — As part of the “Choosing Wisely in Maine” initiative that the American Board of Internal Medicine leads, TAMC is raising awareness about the prevalent issue of over-prescribing antibiotics for sinusitis, also known as a sinus infection.
Photo courtesy of TAMC
DR. BRUCE ALEXANDER of TAMC Family Practice and Internal Medicine examines patient Sharon Murchison of Mapleton. Alexander and other TAMC providers are participating in the “Choosing Wisely in Maine” initiative to raise awareness about the prevalent issue of over-prescribing antibiotics for sinusitis, also known as a sinus infection. All TAMC primary care practices have been provided with literature on the program and will help educate patients on why it is in everyone’s best interest that they no longer issue prescriptions for a sinus infection.
Most sinus infections are viral and do not respond to antibiotics. Sinus infections are rarely caused by bacteria, with other causes including, but not limited to, pollutants, fungal infections and allergies.
According to Maine Quality Counts, an independent health care collaborative committed to improving health and health care for the people of Maine, the “Choosing Wisely” campaign is an initiative “to provide specific, evidence-based recommendations that physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation.” Part of the initiative includes developing a list of five recommendations for such discussions.
“Choosing Wisely” partners include the American Academy of Family Physicians, the American College of Cardiology, the American College of Physicians, the American Geriatrics Society, and many others.
According to Dr. David Weed, medical director of TAMC Medical Group, one of the recommendations from the local “Choosing Wisely” campaign is to improve providers’ judicious use of antibiotic therapy for patients with mild to moderate sinusitis.
“The use of antibiotics when they are not needed can cause a number of unwanted negative effects,” said TAMC Chief Operating Officer/Chief Medical Officer Jay Reynolds, M.D.
Nationwide, sinusitis accounts for 16 million office visits and $5.8 billion in annual health care costs. According to Reynolds, when antibiotics are used inappropriately, a patient’s money is essentially wasted.
“In this era of increasing health care expenses, keeping waste out of the equation takes on more importance,” said Reynolds.
In addition to health care costs, the over-prescription of antibiotics poses a public health threat by increasing the risk of antibiotic resistance.
“The overuse of antibiotics can lead to the development of bacteria that are resistant to those antibiotics, potentially taking away the very tools we use to combat them,” said Reynolds.
Many patients suffering from sinusitis seek relief from their medical providers and anticipate a prescription of antibiotics to alleviate symptoms.
“It is abundantly clear that a significant number of patients look to their providers for antibiotics for various respiratory tract infections including sinusitis, otitis media, and pharyngitis,” said Weed. “We as a medical practice have contributed to this problem as well, in that the threshold to prescribing antibiotics for any of these illnesses has been quite low.”
According to Weed, both patients and providers could benefit from an increased awareness regarding this issue.
“Antibiotics are prescribed in more than 80 percent of the outpatient visits for acute sinusitis, despite the fact that a significant number of these patients do not meet criteria,” he said. “The majority of these patients will get better with symptomatic treatment and these recommendations would be made to them with a visit to their primary care provider.”
In an effort to reduce the risk of acquiring a sinus infection, the Center for Disease Control advises individuals to practice good hand hygiene, keep themselves and their children up to date with recommended immunizations, avoid smoking or secondhand smoke, and avoid close contact with people who have colds or other upper respiratory immunizations.
For more information on the “Choosing Wisely” campaign, visit www.choosingwisely.org.
