Teatments based on behaviour could reduce prescription drug use

New psychological treatments - behavioural medicine - could significantly reduce the need for drug treatments for some conditions, cutting health system costs says an editorial in this week's British Medical Journal.

Behavioural medicine - using treatments borrowed from psychology such as cognitive behavioural therapy - has the potential to reduce pain, argue the authors. Treating a patient with a system of behavioural instructions before surgery, for instance, can lower the amount of anaesthetic required during the operation, and cut the time they need to stay in hospital.

This style of medicine could also replace prescribed drugs for some conditions, say the authors. In one study diabetes rates were cut by 58% in a high risk group of patients, by intensively promoting exercise and weight loss - a higher success rate than achieved using conventional medicine.

Using behavioural techniques to reorganise clinical teams has also been shown to result in lower blood pressure in hypertensive patients - sometimes more effectively than prescribed drug treatments.

Introducing the approach more widely has been slow, however. Doctors are used to using drugs and surgery to control disease rather than behavioural techniques, say the authors.

The pharmaceutical industry also exerts a strong influence, being the chief source of funding by far for research on new treatments. "The major imbalance between investments in pharmaceutical development and in understanding and supporting health related behaviours must be of concern," say the authors.

Things are changing however. The UK has now established a Society of Behavioural Medicine, and research on these therapies is to be included on the Cochrane Database - the 'central bank' doctors use for the latest evidence-based treatments.

Behavioural medicine could make significant cost savings for health services, as well as empower patients in managing their conditions, the authors conclude.