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Choosing Wisely

There are “Choosing Wisely” campaigns to combat the overuse of health care in more than 20 countries. In each country, campaigns partner with national clinician societies to making recommendations about unnecessary and commonly overused medical practices that can harm to patients. In 2016, leaders from seven Choosing Wisely campaigns — in the United States, Canada, Italy, the Netherlands, Switzerland, Japan and Australia — participated in a consensus process to prioritize their top 10 recommendations across campaigns. Selections were guided by the frequency of occurrence of the overused practices, measurability of the recommendations, and the potential to avoid harm to patients. The top 10 were  chosen from among more 1,000 recommendations across specialties and countries. 

The cases below show the way different countries are implementing innovations in practice and research based each of the top 10 recommendations.

See some additional Choosing Wisely resources:

Infographic: The Harms of Overuse in Health Care  Podcast Episode 

Publications and Reports Resource Page  Feature Article

Choosing Wisely Recommendation 6: Don’t use antipsychotics as the first choice to treat behavioral and psychological symptoms of dementia.
Improving Health Care Quality

Don’t Use Antipsychotics as the First Choice to Treat Behavioral and Psychological Symptoms of Dementia

The Choosing Wisely Canada Geriatrics and Psychiatry lists of recommendations include avoiding unnecessary antipsychotics for elderly adults. Antipsychotics should only be prescribed to treat behavioral symptoms of dementia when other strategies have failed. Long-term use of antipsychotics in elderly patients has significant harms and side effects, such as increasing risks of confusion, falls, pneumonia and delirium.

Case Study / Apr 11, 2019

Choosing Wisely Recommendation 8: Don’t Use Antimicrobials To Treat Bacteriuria In Older Adults Unless Specific Urinary Tract Symptoms Are Present
Improving Health Care Quality

Don’t Use Antimicrobials to Treat Bacteriuria in Older Adults Unless Specific Urinary Tract Symptoms Are Present

Older adults commonly have bacteria present in their urine, a condition known as bacteriuria. Clinicians and patients often assume that this is a sign of a urinary tract infection requiring antibiotics. However, if patients have no other symptoms, such as fever or a burning sensation when urinating, they do not need antibiotics. Unnecessary use of antibiotics leads to antimicrobial resistance and can have very harmful side effects like kidney failure and antibiotic-related diarrhea.

Case Study / Apr 04, 2019