Adherence to the American Urological Association Choosing Wisely® Recommendations

The AUA (American Urological Association) initially published 5 Choosing Wisely® recommendations in 2013 to highlight best practices in urology. In this study we evaluated the impact and adherence to the Choosing Wisely recommendations among AUA members.

A survey of the AUA membership was conducted in 2014, 1 year after publication of the Choosing Wisely statements, to determine familiarity with the initiative, influence on practice and potential methods of preferred communication about such efforts. To better understand the desired method of information distribution, questions about AUA guideline communication were used as a standard for comparison.

There were 605 respondents, representing an 8.1% response rate from all AUA members. The majority were 55 to 64 years old (34.3%), in a urology group practice (41.4%) and in practice for more than 20 years (48.9%). Overall 43.0% of respondents claimed to know of the existence of Choosing Wisely recommendations and 75.8% found the Choosing Wisely recommendations helpful to their practice. Respondents cited lack of publicity (45.0%) as the most common barrier to wider adoption.

This study highlights the need for improved communication regarding the Choosing Wisely initiative and future updates. Our results show that physicians specifically would be willing to use Choosing Wisely recommendations more in their clinical practice if they were adapted into their electronic medical record. Ongoing work is needed to develop a tool to promote and evaluate adherence to the Choosing Wisely recommendations that could be integrated into an electronic medical record.