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Choosing Wisely attaining critical mass

Author: Rob Gill
30 July 2015
  • Representatives of the first organisations to sign up to Choosing Wisely in April - now six more have added their voices to the call

A further six Australian and New Zealand professional colleges and societies have joined Choosing Wisely, the initiative that addresses unnecessary medical practices and questions tests, treatments and procedures of proven low value.

The campaign continues to build momentum since Choosing Wisely came on stream in Australia in April, when five peak specialty medical organisations signed up to the initiative facilitated locally by NPS MedicineWise.

The latest supporters include:

  • the Royal Australian and New Zealand College of Ophthalmologists,
  • the Australian College of Nursing,
  • the College of Intensive Care Medicine of Australia and New Zealand,
  • the Australian and New Zealand Intensive Care Society,
  • the Society of Hospital Pharmacists of Australia and,
  • the Australian Physiotherapy Association.·   

Choosing Wisely has expanded globally since its launch three years ago by the American Bureau of Internal Medicine (ABIM) Foundation, to the extent that more than 60 medical organisations support it in the US alone.

NPS MedicineWise Client Relations Manager Dr Robyn Lindner said, “We are delighted to welcome another six colleges and specialty societies.

“Participation continues to broaden across the medical profession with the introduction of specialties including ophthalmology and intensive care medicine. It also sees the welcome addition of other health professionals with nursing, hospital pharmacy and physiotherapy now represented.”

Palliative Care Australia (PCA) backs the initiative, with CEO Liz Callaghan saying, “Choosing Wisely aims to highlight the waste of these unnecessary treatments. It encourages doctors to establish ‘goals of care’ with patients and their families. PCA believes this will mean more Australians will have the opportunity to undertake important conversations about tests, treatments and procedures where evidence shows they provide limited or no benefit and in some cases can lead to harm,” Ms Callaghan said. “PCA’s stance goes hand in glove with those intentions.”

The new participants will release recommendations early next year.

ehospice reported on Choosing Wisely’s Australian arrival, highlighting recommendations from the colleges of Emergency Medicine, General Practitioners, Radiologists and Pathologists, and the Society of Clinical Immunology and Allergy who identified 24 tests and treatments. They included treatments like food allergy testing, prostate cancer and vitamin D screening, monitoring of type 2 diabetes, benzodiazepine prescribing, emergency medicine procedures and ankle and spine imaging.

The issue of inappropriate tests and treatments was revisited on the US-based Geripal blog by Dr Claire Larson, who wrote of patients taking 10, 20 or more medications which were continually being added to, without any being removed. She said that most were prescribed with good intentions and defined indications but, like the medications, such indications expired.

Dr Larson cited a 65 year-old man with advanced early onset Alzheimer’s disease, who had been on a particular medication for the past decade. His neurologists were reluctant to stop the medication for fear of his worsening, despite recognising that there was no evidence to support any benefit from its continued use.

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