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Helping Physicians Help Patients to Choose Wisely

Helping Physicians Help Patients to Choose Wisely

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Helping Physicians Help Patients to Choose Wisely

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  1. Helping Physicians Help Patients to Choose Wisely

  2. Choosing Wisely® Goal • …help physicians, patients and other healthcare stakeholders think and talk about appropriate medical care including overused or misused tests and procedures that provide little benefit, or even potential harm

  3. Choosing Wisely® • Aims to promote conversations between physicians and patients by helping patients choose care that is: • Supported by evidence • Not duplicative of other tests or procedures already received • Free from harm • Truly necessary

  4. Choosing Wisely® • Created by the American Boards of Internal Medicine Foundation • Consumer Reports is creating patient/caregiver information to supplement the lists created by and for physicians

  5. American Academy of Hospice and Palliative Medicine List • Don’t recommend percutaneous feeding tubes in patients with advanced dementia • Don’t delay palliative care for a patient with serious illness • Don’t leave an ICD activated when patient wants comfort care only

  6. American Academy of Hospice and Palliative Medicine List • Don’t recommend more than a single fraction of palliative radiation for an uncomplicated painful bone metastasis • Don’t use topical lorazepam (Ativan), diphenhydramine (Benadryl), haloperidol (Haldol) (“ABH”) gel for nausea

  7. American Geriatrics Society • Don’t recommend percutaneous feeding tubes in patients with advanced dementia • Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia • Avoid using medications to achieve hemoglobin A1c <7.5% in most adults age 65 and older

  8. American Geriatrics Society • Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium • Don’t use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present

  9. Hospice is Your Partner • In facilitating advance care planning discussions • Whenever you need a palliative care consultation for a patient • Breaking bad news • Goal setting • Pain and symptom management

  10. Learn More • www.choosingwisely.org • www.caringinfo.org • Artificial Nutrition and Hydration • Asking Tough Questions • NHPCO Position Statement on ICDs and Hospice • INSERT YOUR WEB ADDRESS HERE