Research is mounting against the common practices of prescribing thickened liquids, conducting spine implants for back pain and suspending blood pressure medicines before surgery, The New York Times reported Sept. 14.
These practices are commonplace, but some healthcare workers have cast caution for years because of poor clinical results. More studies now present evidence backing these doubts, the Times reported:
1. Thickened liquids are used in the hopes of preventing aspiration pneumonia, but researchers at Northwell Health's Feinstein Institutes for Medical Research in Manhasset, N.Y., found no mortality difference between thick and thin liquid diets in about 8,000 hospital patients. JAMA published the results May 6.
The researchers also discovered no significant difference in length of stay, readmissions or death rates, according to findings published in July.
2. A discourse among spine care experts targets the efficacy of implanting spinal cord stimulators in patients with chronic back pain. Research has shown little benefit of the practice, but evaluating pain is a tricky task. The methodology of a new spine stimulation study of 7,500 patients has also been questioned because of how it tests pain relief.
3. Patients who take ACE inhibitors or angiotensin II receptor blockers are often advised to skip their blood pressure medication doses before scheduled surgeries. The reasoning is a patient's blood pressure might drop too low and cause complications, but three recent studies found complication frequency was similar among those who did and did not halt their regimen.
Cardiac operations are the exception, Matthieu Legrand, MD, PhD, lead author of one of the studies, told the Times.
"There are plenty of things we do in medicine that have no evidence," Dr. Legrand, an anesthesiologist and critical care physician at the University of California San Francisco, told the Times.
Medical practices continue "because we have always done them, so they just keep on happening," Dr. Legrand said.
These practices might work for some patients, but experts said they are blanket generalizations and should be unraveled.