The Journal of Community Health Management 2023;10(1):1–2
Content available at: https://www.ipinnovative.com/open-access-journals
The Journal of Community Health Management
Journal homepage: https://www.jchm.in/
Editorial
Quaternary prevention: The antidote to medical overuse!
Badrinarayan Mishra
1,
*, Nidhi D Sinha
2
, Bidushi Mishra
3
1
Dept. of Community Medicine, R D Gardi Medical College, Ujjain, Madhya Pradesh, India
2
Dept. of Dentistry, R D Gardi Medical College, Ujjain, Madhya Pradesh, India
3
People’s College of Dental Sciences, Bhopal, Madhya Pradesh, India
ARTICLE INFO
Article history:
Received 15-02-2023
Accepted 22-02-2023
Available online 28-04-2023
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On a conventional note, Man has managed diseases
through preventive approaches before the availability of
any specific treatment modality. In fact, at the onset, most
of the disease entities are handled through this method as
there is a dearth of empirical knowledge. But, in recent
time the field of medical sciences have expanded and
developed many armors, especially for established disease
entities. This when coupled with digital dissemination of
information, wider coverage of the populace by health
insurance schemes, and dented ethical morale of healthcare
providers has created a new challenge; the issue of medical
overuse.
In its’ simplest form medical overuse represents
the issues of unwanted investigation and overtreatment
that lack patient benefit and in multiple instances
is even counterproductive.
1
Overdiagnosis, over-testing,
overtreatment, diagnosis of abnormalities unrelated to
disease, unnecessary medical evaluation, incorrect practice,
or unwanted care are some of them.
2
Additionally, risk
factors are increasingly being addressed as diseases,
asymptomatic groups with low risk are frequently screened,
and pre-disorders are frequently classified as manifest
diseases.
3,4
A good illustration is threshold lowering by
relocating the line dividing health and sickness is serum
cholesterol levels.
5
* Corresponding author.
E-mail address: badrinmishra@gmail.com (B. Mishra).
Over time, there is a growing recognition of the fact
that medical overuse includes unnecessary health care
that provides no benefit to patients or puts them at risk
of harm that outweighs any potential benefit.
6,7
More
often than not, asymptomatic individuals are at risk of
being labeled as patients. This brings in unnecessary
anxiety and lowers the quality of life of those who
are a victim of this malicious practice.
7
Furthermore,
unnecessary medicine contributes to rising healthcare
costs and a misallocation of scarce resources.
8,9
This
increasingly visible situation has emerged as a significant
healthcare issue, which is well substantiated by Barbara
Stanfield’s report in 2000, which has put iatrogenic
events as the third leading cause of death in the United
States.
10
Furthermore, in 2003, The World Organization of
National Colleges, Academies, and Academic Associations
of General Practitioners/Family Physicians (WONCA) and
the World International Classification Committee (WICC)
recognized medical overuse as a cause of concern and
advocated Quaternary Prevention(P4) as the modality to
handle this issue.
11
Taking cognition of this and a growing number of
studies and healthcare campaigns across the globe, different
associations and agencies have risen up to the occasion. One
such is the American Board of Internal Medicine, whose
"Choosing Wisely" program (2015), is a distinct example
of handling medical overuse by adopting the Quaternary
https://doi.org/10.18231/j.jchm.2023.001
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