Choosing Wisely Update - September 2019


25 Sep 2019

New program: Opioids and the bigger picture when treating chronic pain

A Choosing Wisely Australia recommendation from the Faculty of Pain Medicine (FPM) on the use of opioids for chronic non-cancer pain (CNCP) is part of the latest GP educational visiting program by NPS MedicineWise, which starts on 1 October.

Recognising the challenges of supporting patients with CNCP, the program – Opioids and the bigger picture when treating chronic pain – aims to equip health professionals with tools and resources to reduce the harms of opioids while ensuring adequate pain management and quality of life for patients. The program also aims to empower consumers to make more informed decisions about opioids through a suite of consumer-oriented resources. 
 
FPM advises not to continue opioid prescription for CNCP without ongoing demonstration of functional benefit, periodic attempts at dose reduction and screening for long-term harms. Find out more


Growth in GP awareness of RACGP PPI recommendation

An evaluation of an NPS MedicineWise 2018 educational program on the management of gastro-oesophageal reflux disease (GORD) with proton pump inhibitors (PPIs) in primary care has increased GP awareness of recommendations developed by The Royal Australian College of General Practitioners and published under the Choosing Wisely Australia initiative.

The Starting, stepping down and stopping medicines program included recommendations from The RACGP and the Gastroenterological Society of Australia. 


One of the program’s aims was to grow GP awareness of the RACGP recommendation and GPs were encouraged to regularly review patients with GORD on PPIs, with the aim of reducing or ceasing altogether. 

A GP survey conducted in February 2019 asked GPs to rate their agreement with the RACGP statement before and after participating in the NPS MedicineWise progr am.  The result was a significant 13% increase in GP awareness of the RACGP recommendation after participating in the program.


Townsville doc welcomes conversation about low-benefit care

An informed conversation between patients and clinicians about low-benefit care is long overdue according to Townsville Hospital emergency department deputy director Dr Natalie Ly (left).

The Townsville Hospital and Health Service has signed up to Choosing Wisely Australia which brings together medical colleges, societies and healthcare associations led by clinicians across the country.

Dr Ly said the ultimate vision of a meaningful discussion about low-benefit care would be in the best interests of patients.

“I see a real benefit in having a genuine conversation that just because a test is available it doesn’t necessarily mean it is beneficial and, in some cases, it can be harmful,” she said.

“We have 250 patients present to the emergency department every day and most people in our community expect that when they come to hospital, they will receive a test, procedure, or medication.

“The reality is that in busy emergency departments it can be a challenge to have this conversation with every patient and at times, it may easier to provide the requested treatment, even though you know it is of little to no benefit to the patient.”

Choosing Wisely Australia provides community awareness and education about low-benefit care, that informs patients and arms them with the right questions to ask their care providers.

Dr Ly said everyday examples of low-benefit care included prescribing antibiotics for viral infections and X-rays for ankle sprains.

“There are clinical diagnostic tools available to our clinicians to assess if any ankle has a sprain or fracture,” she said.

“By using these tools, we can avoid unnecessary imaging, unnecessary radiation exposure, unnecessary time spent in the department.”

Dr Ly said another benefit of Choosing Wisely Australia is it gives a name to low-benefit care and will hopefully make the community think about their care choices, including no test and/or treatment being a legitimate care option.

Find out how to become a Choosing Wisely Australia Champion Health Service


Be Medicinewise Week: 5 Questions, 13 languages

Thank you to our members and supporters who participated in this year’s Be Medicinewise Week, held by NPS MedicineWise from 19-25 August. The focus this year was encouraging Australians to get to know the language of medicines, that it was important to understand and communicate about medicines for their safe and effective use.

Choosing Wisely Australia’s 5 questions to ask your doctor resources for consumers and carers was promoted throughout the week. These are available for download in 13 languages, including English. Read the media release

 


Recent articles in BMJ, Hospital + Healthcare

  • The results of a study, funded by Monash Health, to examine how patients perceived shared decision-making regarding CT scan referrals and, more generally, their perspectives on using the Choosing Wisely 5 questions in discussions with their GPs, were recently published in a BMJ Open article. The article was co-authored by health professionals and researchers in Victoria.
 
  • The implementation of Choosing Wisely in Australia’s Health Services, including a scale-up of the initiative in Victoria, is the focus of a new article published by Hospital + Healthcare.

Showcase your activities

  • We would love to share your Choosing Wisely activities, so don’t forget to send any news through to choosingwisely@nps.org.au
 
  • Also, don’t forget to recognise your colleagues for championing Choosing Wisely in your organisation. We have created a special awards kit just for that purpose. Find out more

Last reviewed 20 September 2019