Current Affairs · · Prelims · Science & Technology

Overtreatment and overmedication raise patient-safety concerns in India

Excess tests, medicines and procedures can harm patients and add to healthcare costs, even as many Indians struggle to access essential care. A review of Indian studies raises concerns about potentially inappropriate prescriptions among older adults. Evidence-based decisions, better primary care, informed consent and prescription reviews are important for patient safety.

Event date:

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  1. Context1 / 5
    • Overtreatment and overmedication describe unnecessary or excessive clinical interventions that may cause harm without corresponding benefit.
    • India faces a dual challenge: some patients receive unnecessary tests, medicines or procedures, while others cannot obtain essential care.
    • Physician Chandrakant Lahariya's 2026 book, Pill-Free, examines the risks of low-value prescribing and testing.
    • The wider public-health concern is to improve patient safety, affordable care and universal health coverage without discouraging necessary treatment.
  2. Key highlights2 / 5

    Why unnecessary care can occur

    • Excess testing: Low-value screening can produce findings that trigger more investigations or procedures with little clinical benefit.
    • Fragmented treatment: Prescriptions from multiple specialists may overlap if medicines are not reviewed together.
    • Financial incentives: Payment linked to service volume can create pressure for additional procedures; this does not establish wrongdoing by any individual.
    • Patient expectations: More medicines or costly tests may be mistaken for better care.
    • Defensive medicine: Fear of complaints can prompt investigations beyond what the clinical situation justifies.

    Example: Antibiotics usually do not treat uncomplicated viral infections, and unnecessary use can contribute to antimicrobial resistance (AMR).

    Remember: Whether a treatment is appropriate depends on the individual patient's condition and medical evidence.

  3. Key concepts3 / 5

    Key medical concepts

    ConceptMeaning
    OvertreatmentIntervention where expected benefits do not justify the risks or burdens.
    OverdiagnosisDetection of a condition that would not cause symptoms or harm in a person's lifetime.
    PolypharmacyUse of multiple medicines concurrently, commonly five or more.
    DeprescribingClinician-supervised reduction or withdrawal of unnecessary or potentially harmful medicines.

    What Indian research found

    • A 2021 systematic review of 27 studies involving older adults reported pooled estimates of 49% polypharmacy and 28% potentially inappropriate medication use.
    • These findings are not nationally representative estimates. The included studies differed substantially in setting and participants.

    Prelims distinction: Polypharmacy is not automatically inappropriate; several medicines may be necessary for a patient with multiple illnesses. Changes to prescriptions should be medically supervised.

  4. Note4 / 5

    Health and economic consequences

    • Patient safety: Unnecessary interventions can lead to adverse drug effects, procedural complications and avoidable distress.
    • AMR: Inappropriate antibiotic use can contribute to drug-resistant infections.
    • Financial burden: Household out-of-pocket payments made up 39.4% of India's total health expenditure in 2021–22. This reflects all out-of-pocket healthcare spending, not just overtreatment.
    • Inequality: Unnecessary expenditure can add to household financial pressure while essential care remains inaccessible to others.

    Ethical principles (GS4)

    • Non-maleficence: Avoid preventable harm from low-value interventions.
    • Autonomy and informed consent: Explain expected benefits, risks and reasonable alternatives.
    • Distributive justice: Use scarce healthcare resources fairly, prioritising clinical need.
  5. Note5 / 5

    Established initiatives

    • WHO's Medication Without Harm (2017): The third Global Patient Safety Challenge sought a 50% reduction in severe, avoidable medication-related harm over five years, with emphasis on high-risk situations, polypharmacy and care transitions. This was a target, not a verified result.
    • Choosing Wisely (2012): A campaign launched in the United States to encourage informed discussion of unnecessary tests, medicines and procedures.
    • ICMR prescribing guidance: Indian antimicrobial-treatment guidelines support appropriate use and stewardship of antibiotics.

    Suggested measures

    • Strengthen primary care and coordination between specialists to reduce overlapping prescriptions.
    • Review medication lists, especially for older patients and those managing several illnesses.
    • Improve clinical quality audits and prioritise evidence-based decisions over procedure counts.
    • Support informed consent through clear explanations of likely benefits, risks and alternatives.
    • Align incentives with outcomes and ensure that essential healthcare remains accessible.

    Final takeaway: Good healthcare means providing necessary, evidence-based care—not automatically more tests or medicines. Do not stop prescribed medicines without professional advice.

Sources

Syllabus

PaperSubjectSub-topic
PrelimsScience & TechnologyWHO Medication Without Harm; polypharmacy, overdiagnosis, deprescribing and antimicrobial resistance
GS2Social JusticeHealthcare access and affordability; patient safety, public-health service delivery and universal health coverage
GS2GovernanceHealthcare regulation, clinical standards, accountability and rational medicine use
GS4EthicsMedical ethics, non-maleficence, autonomy, informed consent and distributive justice

Topics

GovernanceDiseasesHealth

Practice questions

  1. With reference to the rational use of medicines, consider the following statements: 1. Polypharmacy commonly means concurrent use of five or more medicines. 2. Polypharmacy is always medically inappropriate. 3. Deprescribing involves supervised reduction or withdrawal of unnecessary medicines. Which of the statements given above are correct?

    1. 1 and 2 only
    2. 1 and 3 only
    3. 2 and 3 only
    4. 1, 2 and 3
    Show answer

    Answer: B. Statements 1 and 3 are correct. Statement 2 is incorrect: several medicines can be clinically appropriate when a patient has multiple conditions, and a qualified professional should assess whether changes are needed.

    Difficulty: medium · statement

  2. Consider the following statements about WHO's Medication Without Harm initiative: 1. It was launched in 2017. 2. It is WHO's third Global Patient Safety Challenge. 3. It focuses exclusively on developing new antibiotics. Which of the statements given above are correct?

    1. 1 only
    2. 2 and 3 only
    3. 1 and 2 only
    4. 1, 2 and 3
    Show answer

    Answer: C. Statements 1 and 2 are correct: the third WHO Global Patient Safety Challenge was launched in March 2017. Statement 3 is incorrect because its aim is to reduce preventable medication-related harm, particularly in high-risk situations, polypharmacy and transitions of care.

    Difficulty: easy · statement

  3. Consider the following statements about patient safety: 1. Inappropriate antibiotic use can contribute to antimicrobial resistance. 2. Overdiagnosis can lead to unnecessary treatment. 3. Concerns about overdiagnosis mean all medical screening programmes should be discontinued. Which of the statements given above are correct?

    1. 1 and 2 only
    2. 2 and 3 only
    3. 1 and 3 only
    4. 1, 2 and 3
    Show answer

    Answer: A. Statements 1 and 2 are correct. Statement 3 is incorrect because evidence-based screening can be beneficial when expected benefits outweigh potential harms for the population and individual.

    Difficulty: medium · statement

Mains practice

Answer-writing practice on this article. Attempt it first, then open the hints.

  1. GS2 · 150 words

    Examine the causes and consequences of overtreatment and overmedication in India's healthcare system. Suggest measures to promote rational medical care.

    Show hints
    1. Explain unnecessary testing, fragmented prescribing, patient expectations and possible volume-based financial incentives.
    2. Discuss avoidable adverse effects and antimicrobial resistance as patient-safety risks.
    3. Use the 39.4% out-of-pocket share of total health spending in 2021–22 as context, not as the cost of overtreatment.
    4. Recommend coordinated primary care, medication reviews and evidence-based clinical audits.
    5. Conclude with affordable access to essential treatment and patient-centred decision-making.
  2. GS4 · 150 words

    "More medical intervention does not necessarily mean better healthcare." Discuss with reference to medical ethics and patient autonomy.

    Show hints
    1. Apply non-maleficence to unnecessary tests, adverse effects and preventable harm.
    2. Balance beneficence with the need to offer clinically justified treatment.
    3. Explain informed consent and respectful discussion of benefits, risks and alternatives.
    4. Discuss professional integrity, conflicts of interest and fairness in allocating scarce resources.
    5. Conclude that rational care needs evidence, patient choice and supervised medication changes.