April 28, 2015
Choosing Wisely Australia® launches —kick-starting a national conversation about more appropriate health care. In a first for Australia, medical colleges and societies have united to take the lead on identifying those tests, treatments and procedures they think are of proven low value or carry an unnecessary risk.
Among the lists are recommendations on food allergy testing, prostate cancer screening, vitamin D screening, monitoring of type 2 diabetes, benzodiazepine prescribing, emergency medicine procedures and ankle and spine imaging.
The initiative is health profession-led and is facilitated by NPS MedicineWise. The national medical societies and colleges releasing recommendations today are the Australasian College for Emergency Medicine, the Australasian Society of Clinical Immunology and Allergy, The Royal Australian College of General Practitioners, The Royal Australian and New Zealand College of Radiologists and The Royal College of Pathologists of Australasia.
Imaging for low back pain? Think again
The ordering of diagnostic imaging for patients with non-specific acute low back pain is listed as a test to question. “Low back pain is the third most common health complaint seen by Australian general practitioners. Imaging for acute low back pain is one of the tests to feature on our list—it is not recommended for patients with non-specific low back pain, the majority of these patients,” says Dr Gregory Slater from the Royal Australian and New Zealand College of Radiologists (RANZCR).
“Imaging is only indicated initially if the patient has indicators of a serious spinal condition, spinal canal stenosis or sciatica. Implementing this recommendation on lower back pain, as well as our other Choosing Wisely Australia recommendations on imaging will result in improved imaging access to appropriate and quality tests and better patient care.”
Treatment for heartburn and reflux? Question long-term use
Long-term use of one of Australia’s most prescribed medicines, called proton pump inhibitors (PPIs) which are used to treat stomach acid and reflux, is also listed as a treatment to question. Last financial year the cost of anti-acid medication was $450 million, with prescription volume increasing 9% annually.
“One of our ‘top 5’ items is to not prescribe these medicines long term in patients with uncomplicated disease whose symptoms are well-controlled without regular attempts at reducing dose or ceasing. The treatment is on the RACGP Choosing Wisely list because unnecessary long term use can potentially lead to adverse effects alongside a significant cost to both patients and the health system,” says Dr Frank R Jones, President of the Royal Australian College of General Practitioners (RACGP).
Stimulating informed conversations
“The launch of Choosing Wisely Australia will stimulate informed conversations about the right care, with the ultimate goal to ensure delivery of high-quality healthcare for Australians by reducing inappropriate care. The initiative challenges the notion that more is always better when it comes to healthcare. Australians can use their voice and ask what the risks are of a test, treatment or procedure,” says NPS MedicineWise CEO Dr Lynn Weekes.
“NPS MedicineWise is proud to be facilitating Choosing Wisely in Australia, and I congratulate the five inaugural colleges and societies involved in this initiative for releasing their evidence-based recommendations today and sharing them with Australian health professionals and consumers. These lists are just the beginning of a national conversation about appropriate healthcare.”
Choosing Wisely Australia will continue as a new voice in Australian healthcare as other medical colleges and societies come on board and release their own lists. Several are already lined up to release theirs before the end of 2015.
Choosing Wisely Australia is modelled after the successful Choosing Wisely campaign in the United States, launched in 2012 by the American Board of Internal Medicine’s ABIM Foundation.
Clear, evidence-based and straightforward materials have been developed for both consumers and health professionals to support better decisions. These are available on the Choosing Wisely Australia website launching today at www.choosingwisely.org.au
Full copies of the “5 things clinicians and consumers should question” from each participating medical college and society are now available on the official website.
Media are invited to attend the official launch of Choosing Wisely Australia at 10:00am on 29 April 2015 at NPS MedicineWise, Level 7, 418A Elizabeth Street, Surry Hills. CCI Newswire