The global medical fraternity is nowadays waking up to the hazards of ‘over-prevention’, ‘over-diagnosis’, ‘over-prescription’ and ‘over treatment’ which, besides significantly jacking up the health care costs, has serious consequences like the emergence of antibiotic resistance. However, the concept has not yet percolated to the grass-root level in India.
The theory of ‘quaternary prevention’ was, according to a letter published in the latest issue of Journal of Dr. NTR University of Health Sciences (NTRUHS), is defined as ‘action taken to identify a patient or a population at risk of over-medicalization to protect them from invasive medical interventions and provide procedures which are scientifically and medically acceptable’.
Over-medicalization is in fact a combination of the things that are ‘overly done’ by some medical professionals unmindful of the inherent dangers.
Authors of the letter Kalaivani Annadurai, Raja Danasekaran, Geetha Mani and Jedadeesh Ramasamy of Department of Community Medicine at Sri Sathya Sai Medical College and Research Institute, Kanchipuram, stated that quaternary prevention include the recommendations for avoidance of screening without clinical evidence, advising vaccines without indications, inappropriate use of antibiotics and unnecessary use of drugs such as pain-killers, anti-depressants and application of incorrect rehabilitation techniques.
Quoting from a report released by the Centre for Disease Control and Prevention (CDC), they said each year more than two million Americans acquire infections that are resistant to antibiotics and 23,000 die as a result.
A senior administrator of NTRUHS told The Hindu that the need for quaternary prevention was more in India as health care in both the public and private sectors was marred to a significant extent by unethical practices. The concept has to be popularised to help the common people in acquiring quality treatment at affordable cost but it was fraught with serious challenges in the existing setup, he observed.
