Choosing Wisely - An international and multimorbid perspective

Area of Science:

• Medical Ethics and Health Services Research
• Evidence-Based Medicine Implementation

Background:

• Medical interventions can be non-beneficial or harmful, leading to the Choosing Wisely campaign.
• The campaign generates "top five" lists of unnecessary low-value services across specialties.
• Numerous evidence-based recommendations have been published, with international adoption.

Purpose of the Study:

• To explore the challenges and potential of the Choosing Wisely campaign in various countries.
• To highlight the need for specific Choosing Wisely principles for patients with multimorbidity (MM).
• To advocate for research into overuse in MM clusters and the development of targeted recommendations.

Main Methods:

• Review of the Choosing Wisely campaign's global initiatives and impact.
• Analysis of the challenges in applying Choosing Wisely principles to complex patient populations.
• Identification of research needs for developing recommendations for multimorbidity management.

Main Results:

• Choosing Wisely campaigns have been adopted internationally, aiming to shift medical culture.
• Internal medicine societies in Switzerland and Germany have launched specific initiatives (Smarter Medicine, Klug entscheiden).
• Managing multimorbidity presents a significant challenge for developing effective Choosing Wisely recommendations.

Conclusions:

• Further research is crucial to identify overuse sources in specific multimorbidity clusters.
• Developing targeted recommendations for multimorbidity is essential for reducing low-value care.
• National Choosing Wisely campaigns can pave the way for a global initiative.