These medical treatments offer little or no benefit to patients, according to senior doctors.
But they are routinely prescribed or performed because worried patients put pressure on their doctors.
A survey last year found that 82% of doctors prescribed or performed treatment they knew was unnecessary.
The list was published by the Academy of Medical Royal Colleges as part of its Choosing Wisely to Better Inform Patients campaign.
Academy president Professor Dame Sue Bailey said: ‘We all have a duty to look after healthcare resources, especially when the NHS is under so much pressure, but it’s not the main motivation for this initiative.
âWhat is much more important is that doctors and patients really ask themselves if the particular treatment is really necessary.
“Medical or surgical procedures don’t need to be the only solution a doctor offers and most certainly doesn’t always mean better.”
The list was compiled by experts from 11 medical specialties, as well as by patient groups.
- Alcohol – Giving fluids directly into a vein while under the influence of alcohol will not make you feel better any faster.
- Back pain – if you have back pain and there are no other features of concern, such as compression of the nerve roots, you are unlikely to need tests such as x-rays.
- Blood transfusions (platelets) – you should only have a platelet transfusion when there is a moderate to high risk of bleeding.
- Children with Broken Wrists – Small fractures on one side of the wrist, commonly known as loop fractures, do not normally need a cast. They can usually be treated and improve just as quickly with a removable splint. There is usually no need for follow-up in a fracture clinic either.
- Broken feet – small fractures at the base of the fifth metatarsal, a bone on the outside of the foot, usually don’t need to be put in a cast because they heal just as quickly in a removable boot.
- Calcium test – the calcium test is used when there are symptoms of kidney stones, bone disease, or nervous disorders. You do not need to be tested if you have had one in the past three months, unless you are having major surgery or become seriously ill.
- Cancer – Patients with incurable cancer are frequently treated with palliative chemotherapy. Chemotherapy is very toxic. If you have advanced cancer, the use of chemotherapy, the benefit of which is likely to be small and the harm may be great, should be carefully considered.
- Children with bronchiolitis or breathing problems – in most cases, bronchiolitis, which is inflammation of the small airways in the lungs, gets better without treatment. Although seeing your child with difficulty breathing can be painful, acute bronchiolitis should not be treated with medicines called bronchodilators, which cause the bronchi to widen, as they have been shown to have little or no effect.
- Children with constipation – for children with chronic constipation, changes in diet and lifestyle should be considered first to relieve symptoms.
- Children with seizures or epilepsy – if your child has a prolonged seizure, it is better to give medicines that can be dissolved in the mouth than medicines that are injected or given by means of a suppository.
- Children with Flat Head Syndrome – Helmet therapy is not effective in the treatment of plagiocephaly, also known as flat head syndrome. Other treatment options should be considered and discussed.
- Conjunctivitis – if the conjunctivitis is thought to be viral, there is no need to send samples to the lab or treat with antibiotics.
- Birth control coil – if you have a coil (also known as an intrauterine device or IUD) installed to prevent pregnancy, you should learn to verify its placement by feeling the threads inside the vagina. This should be done regularly for the first month after it is applied, then after each of your periods or at regular intervals. You only need to seek professional advice when you cannot feel the threads.
- Cuts and Grains – Studies have shown that tap water is just as effective at cleaning and washing cuts and abrasions as sterile saline.
- Dementia – there are no routine screening programs for dementia. If you think that you or someone you care for is having symptoms, you should talk to a doctor.
- Antidepressants – if your depression is being treated with antidepressants and you think they are not working, your medicine needs to be changed or another medicine added.
- Resuscitation devices – sometimes being kept on resuscitation will not result in significant recovery for you. Likewise, if you are caring for someone in this situation, you should have a discussion with the patient if possible, as well as with specialist clinicians, about the goals that can be achieved with further treatment.
- End-of-life drugs – if you are particularly fragile or have been told you have less than a year to live, you should try to reduce the number of drugs you take to those used only to control your symptoms.
- Minor head injury – minor head injuries do not normally require imaging.
- High blood pressure – you should only consider taking medicines to treat high blood pressure, to prevent heart disease or stroke if you have other risk factors and blood pressure readings consistently above 140-159 / 90-99.
- High cholesterol (statins) – if you are taking statins, which are often prescribed to lower levels of low density lipoproteins (also called ‘bad cholesterol’) at the recommended dose, you do not need to have them checked regularly your cholesterol level, unless you have had any pre-existing conditions.
- Dislocations – some injuries, such as hip and shoulder dislocations, can be treated with medications that make you feel a little drowsy instead of falling asleep. This means that you may not need to go to the operating room and can be treated in an emergency.
- Menopause – if you are over 45, you usually don’t need blood tests to diagnose menopause. Typical symptoms include hot flashes, sweating, and your period can be much lighter or irregular.
- Pregnancy – If you are planning to become pregnant or might be pregnant, you should not be prescribed sodium valproate for the treatment of epilepsy, migraine or bipolar disorder, unless other medicines do not work. If sodium valproate is prescribed, this should only be done after a full discussion of the risks and benefits to you and your unborn child.
- Miscarriage – If you have had an unexplained or recurring miscarriage, drugs like aspirin, heparin, or progesterone should not be used to reduce the risk of further miscarriages.
- Ovarian cyst – if you have a simple ovarian cyst less than 2 inches in diameter and have not had menopause, you are unlikely to need a follow-up appointment or have the levels of a protein called Ca-125 checked.
- Polycystic ovaries – if your doctor suspects that you have polycystic ovaries, you should have a blood test to look for the typical hormonal pattern before further investigations.
- Blood clots during pregnancy – if you are pregnant aspirin is not recommended to reduce the risk of blood clots (called thromboprophylaxis).
- Large Babies – Unless you have diabetes or develop gestational diabetes during pregnancy, ultrasounds should not be used to check if your baby is larger than normal for their gestational age.
- Labor – Electronic monitoring of your baby’s heart is only necessary during labor if you are at greater than normal risk of complications.
- Prostate conditions – unless you are at risk for prostate cancer because of your race or family history, screening for a specific protein produced by the prostate (Prostate Specific Antigen-PSA) does not prolong life. There is a misconception that early detection of PSA is beneficial for detecting prostate cancer in its early stages.
- Psychosis – scans of the head (CT or MRI) can only be used to help diagnose psychosis in specific situations and are not necessary or helpful in all cases.
- Schizophrenia – when discussing the treatment of schizophrenia in adults with your doctor or nurse, you or your lawyer should determine whether oral medications or long-acting medications given by injection are best for you.
- Surgery (when considering an operation) – when considering having surgery, you should be informed about your options and have the opportunity to discuss the potential benefits and potential harms. Your age, type of surgery, and medical conditions may put you at a higher risk of developing complications or even death.
- Surgery (during an operation) – if you are having surgery, day surgery should be considered the default option and is suitable in many cases except for complex procedures. Day surgery allows for faster recovery with less disruption and reduces the risk of nosocomial infections.
- Surgery (preparation for surgery) – you do not need to come to the hospital the day before surgery if you have had the appropriate preparation, testing and discussion with your doctor beforehand. Usually, you will not need routine tests before surgeries of a minor or intermediate nature.
- Vaginal discharge – most vaginal discharge is quite normal and does not need to be seen by a healthcare professional. However, if you experience frequent episodes of vaginal thrush, you should have the skin around your vagina examined by a doctor or specialist nurse. They should rule out other conditions such as an allergy or low hormone levels (vaginal estrogen), rather than starting another treatment for thrush.