Recomendaciones de "No Hacer"
En España, se creó en 2013 el proyecto «Compromiso por la calidad de las sociedades científicas en España» que tiene entre sus objetivos la identificación de estas recomendaciones.
No usar medidas terapéuticas intensivas para conseguir una reducción de HbA1<7,5% en ancianos con multimorbilidad, frágiles, dependientes y con una expectativa de vida <10 años.
Sociedad Científica: Sociedad Española de Geriatría y Gerontología (SEGG), Sociedad Española de Medicina Geriátrica (SEMG)
Sinclair A, Morley JE, Rodríguez- Manas L et al. Diabetes Mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), The European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes. J Am Med Dir Assoc 2012;13:497-502.
Inzucchi SE, Bergenstal RM, Buse JB et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364-1379.
Department of Veterans Affairs and Department of Defense [Accessed January 9,2013]. Clinical Practice guideline for the management of diabetes mellitus(on-line).Available at http://guidelines.gov/content.aspx?id=24192
Dunning T, Sinclair A, Colagiuri S. New IDF Guideline for managing type 2 diabetes in older people. http://www.idf.org/sites7default/files/attachments/DV59-1_Dunning_EN.pdf
Boussageon R, Bejan-Angoulvant T, Saadatian-Elahi M, Lafont S, Bergeonneau C, Kassaï B, Erpeldinger S, Wright JM, Gueyffier F, Cornu C. Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials. BMJ 2011;343:d4169. doi:10.1136/bmj.d4169
Hemmingsen B, Lund SS, Gluud C, Vaag A, Almdal T, Hemmingsen C, Wetterslev J. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011 Jun 15;(6).CD008143. doi:10.1002/14651858.CD008143.pub2
No prescribir fármacos sin considerar el tratamiento previo, evaluar interacciones y el grado de adherencia al cumplimiento.
Sociedad Científica: Sociedad Española de Geriatría y Gerontología (SEGG), Sociedad Española de Medicina Geriátrica (SEMG)
National Committee for Quality Assurance. HEDIS 2013. Requires annual medication review.
Shrank WH, Polinski JM, Avorn J. Quality indicators for medication use in vulnerable elders. J Am Geriatr Soc 2007;55(Suppl 2):S373-S382
Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharm 2007;5.345-51.
Steinman MA, Hanlon JT. Managing medications in clinically complex elders: “There´s got to be a happy medium”. JAMA 2010;304:1592-1601.
Drenth-Van Maanen AC, Van Marum RJ, Knol W et al. Prescribing optimization method for improving prescribing in elderly patients receiving polypharmacy. Drugs Aging 2009;26:687-701.
AGS Choosing Wisely Workgroup. American Geriatrics Society Identifies Another Five Things that Healthcare Providers and Patients Should Question. J Am Geriatr Soc 2014.
No tomar decisiones clínicas en personas mayores de 75 años sin haber evaluado su situación funcional.
Sociedad Científica: Sociedad Española de Geriatría y Gerontología (SEGG), Sociedad Española de Medicina Geriátrica (SEMG)
Lee SJ, Go AS, Lindquist K et al. Chronic conditions and mortality among the oldest old. Am J Public Health 2008;98:1209-14.
. Lubitz J, Cai L, Kramarow et al. Health, life expectancy, and health care spending among the elderly. N Eng J Med 2003;349:1048-55.
Alarcón T, González- Montalvo JI. Situación funcional en el paciente anciano hospitalizado: un marcador pronóstico relevante. Med Clin (Barc) 2008;131(5):173-4.
No indicar colocación de sonda nasogástrica ni gastrostomía percutánea en pacientes con demencia en fase avanzada.
Sociedad Científica: Sociedad Española de Geriatría y Gerontología (SEGG), Sociedad Española de Medicina Geriátrica (SEMG)
Finucane TE, Christmas C, Travis K. Tube feeding in patients with advanced dementia: A review of the evidence. JAMA 1999;282(14):1365-70.
Hanson LC, Carey TS, Caprio AJ, Lee TJ, Ersek M, Garrett J, Jackman A, Gilliam R, Wessell K, Mitchell SL. Improving decision-making for feeding options in advanced dementia; A randomized, controlled trial. J Am Geriatr Soc [ Internet] 2011;59(11):2009-16.
Hanson LC, Ersek M, Gilliam R, Carey TS. Oral feeding options for people with dementia: a systematic review. J Am Geriatr Soc 2011;59(3):463-72
Sampson EL, Candy B, Jones L. Enteral tube feeding for older people with advanced dementia. Cochrane Database Systematic Reviews 2009;2
No indicar el estudio de factores de riesgo genético de demencia (como Genotipo APOE) con fines de asesoramiento genético en el sujeto asintomático.
Sociedad Científica: Sociedad Española de Geriatría y Gerontología (SEGG), Sociedad Española de Medicina Geriátrica (SEMG)
Alzheimer´s disease genetics fact sheet. Baltimore (MD): National Institute on Aging; 2011 Jun 8 Report Nº 11-6424.
American College of Medical Genetics, America Society of Human Genetics. Statement on the use of apolipoprotein E testing for Alzheimer disease. American College of Medical Genetics/ American Society of Human Genetics Working Group on ApoE and Alzheimer disease. JAMA 1995;274(20):1627-9.
Goldman JS, Hahn SE, Catania JW, LaRusse-Eckert S, Butson MB, Rumbaugh M, Strecker MN, Roberts JS, Burke W, Mayeaux R, Bird T. American College of Medical Genetics and the National Society of Genetic Counselors. Genetic Couseling and testing for Alzheimer disease: Joint Practice guidelines of the American College of Medical Genetics and National Society of Genetic Counselors. Genet Med 2011;13(6):597-605.
Hickey SE, Curry CJ, Toriello HV. ACMG Practice Guideline: Lack of evidence for MTHFR polymorphism testing. Genetics in Medicine 2013;15(2):153-6.
No utilizar la medición de los niveles plasmáticos de serotonina con un criterio diagnóstico de trastorno depresivo.
Sociedad Científica: Sociedad Española de Psiquiatría (SEP)
Mössner R, Mikova O, Koutsilieri E, Saoud M, Ehlis Ach, Müller N, Fallgatter AJ, Riederer P. Consensus Paper of the WFSBP Task Force On Biological Markers: Biological Markers in Depression. The World Journal of Biological Psychiatry 2007;8(3):141-174.
No utilizar antipsicóticos para el tratamiento del Trastorno de Ansiedad Generalizada en Atención Primaria.
Sociedad Científica: Sociedad Española de Psiquiatría (SEP)
Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults Management in primary, secondary and community care. Issued: January 2011.NICE Clinical Guideline 113. guidance.nice.org.uk/cg113.
No prescribir los antihistamínicos para el tratamiento del trastorno de pánico.
Sociedad Científica: Sociedad Española de Psiquiatría (SEP)
Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults Management in primary, secondary and community care. Issued: January 2011.NICE Clinical Guideline 113. guidance.nice.org.uk/cg113.
. Freire RC, Machado S, Arias-Carrión O, Nardi AE. Current pharmacological interventions in panic disorder. CNS Neurol Disord Drug Targets 2014;13(6).1057-65.
. Wang HR, Woo YS, Bahk WM. The potencial role of atypical antipsychotics in the treatment of panic disorder. Hum Psychopharmacol 2014;29(5):405-13.
No administrar benzodiacepinas de vida media larga para el tratamiento crónico del insomnio, en personas mayores de 65 años.
Sociedad Científica: Sociedad Española de Psiquiatría (SEP)
Cumming RG, Le Couteur DG. Benzodiazepines and risk of hip fractures in older people: a review of the evidence. CNS Drugs (2003);17:825-837.
Jacobson SA, Pies RW, Katz IR[Eds] Clinical Manual of Geriatric Psychopharmacology. America Psychiatric Publihing Inc.Washington DC, 2007.
Ohyon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews 2002;6(2):97-111.
Ray WA, Thapa PB, Gideon P. Benzodiazepines and the risk of falls in nursing home residents. J Am Geriatr Soc 2000;48:682-685.
Sivertsen B, Krokstad S,Overlandd S, Mykletun A. The epidemiology of insomnia: Associations with physical and mental health. The HUNT-2 Study. J Psychosom Research 2009;67:109-116.
Smith AJ, Tett SE. Improving the use of benzodiazepines- Is it possible? A non-systematic review of interventions tried in the last 20 years. BMC Health Services Research 2010;10:321.
Vinkers DJ, Gussekloo J, Van der Mast RC et al. Benzodiazepine use and risk of mortality in individuals aged 85 years or older. JAMA 2003;290:2942-2943.
No se recomienda en psicosis y esquizofrenia infantil utilizar una dosis de carga de antipsicóticos (técnica de neuroleptización rápida).
Sociedad Científica: Sociedad Española de Psiquiatría (SEP)
National Institute for Health and Care Excellence (NICE). Psychosis and schizophrenia in adults. Treatment and management Clinical Guideline Number 178 (CG178). Feb 2014 [Last Update: March 2014].
Gilbert PL, Harris MJ, McAdams LA, Jeste DV. Neuroleptic withdrawal in schizophrenic patients. A review of the literature. Archives of General Psychiatry 1995;52:173-88.
Akbarpour F, Rezaei O, Khodaie- Ardakani MR, Sheikhvatan M, Goodarzi H, Dolatshahi B. A double-blind placebo controlled trial of bupropion for smoking abstinence and cognition improvement in schizophrenia. Minerva Psichiatrica 2010;51:263-269.
