Together towards optimal patient care: Facilitating the implementation of smarter medicine / Choosing Wisely recommendations thanks to well-informed patients.
smarter medicine
in daily practice
Our goal - added value for patients
When patients come to a consultation well-informed, the time saved by not needing to explain the basics can be used for shared decision-making. Specific questions from patients can be addressed directly and uncertainties can be clarified. Ideally, this can ultimately help avoid unnecessary tests and treatments, promoting optimal patient care.
Content of the website
The recommendations of smarter medicine / Choosing Wisely are explained in an easy language. Users are guided through the topic in an engaging, interactive way and are encouraged to reflect on their attitudes, wishes, and goals. The potential for shared decision-making is illustrated, among others, by outlining advantages and disadvantages.
Benefits for you as a primary care provider
You are supported in patient education, which can make your consultations more effective. A well-informed patient understands that less can sometimes be more. Demands for unnecessary tests and treatments are curbed, helping reduce the gap between patient expectations and guideline-based care. In the end, you deliver the best possible patient care.
Source of the
information provided
Uncomplicated bladder infection
Recommendation from smarter medicine - Choosing Wisely Switzerland:
No routine use of antibiotics for uncomplicated bladder infection and asymptomatic bacteriuria.
References
- https://www.smartermedicine.ch/de/top-5-listen/gynaekologie-und-geburtshilfe incl. the mentioned references on their website
- https://ssi.guidelines.ch/
- Kronenberg A, Butikofer L, Odutayo A, et al.: Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ 2017; 359: j4784.
Antihypertensive therapy
Recommendation from Choosing Wisely Australia:
Don’t commence therapy for hypertension or hyperlipidaemia without first assessing the absolute risk of a cardiovascular event.
References
- https://www.choosingwisely.org.au/recommendations/racgp2
- McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, Christodorescu RM, Daskalopoulou SS, Ferro CJ, Gerdts E, Hanssen H, Harris J, Lauder L, McManus RJ, Molloy GJ, Rahimi K, Regitz-Zagrosek V, Rossi GP, Sandset EC, Scheenaerts B, Staessen JA, Uchmanowicz I, Volterrani M, Touyz RM; ESC Scientific Document Group. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024 Oct 7;45(38):3912-4018. doi: 10.1093/eurheartj/ehae178. Erratum in: Eur Heart J. 2025 Feb 11:ehaf031. doi: 10.1093/eurheartj/ehaf031. PMID: 39210715.
Polypharmacy
Recommendation from Choosing Wisely Australia:
Do not prescribe medications for patients on five or more medications, or continue medications indefinitely, without a comprehensive review of their existing medications, including over-the-counter medications and dietary supplements, to determine whether any of the medications or supplements should or can be reduced or discontinued.
Recommendation from Choosing Wisely Australia:
To avoid adverse medication interactions and adverse drug events in cases of polypharmacy, do not prescribe medication without conducting a drug regime review.
Recommendation from Choosing Wisely Canada:
Don’t continue or add long-term medications unless there is an appropriate indication and a reasonable expectation of benefit in the individual patient.
Recommendation from Choosing Wisely Canada:
Don’t continue medications that are no longer indicated or where the risks outweigh the benefits.
Referenzen
Routine comprehensive check-ups
Recommendation from smarter medicine - Choosing Wisely Switzerland:
No routine comprehensive check-ups in asymptomatic persons.
Recommendation from Choosing Wisely Canada:
Don’t do annual physical exams on asymptomatic adults with no significant risk factors.
References
Advance directive
Recommendation from smarter medicine - Choosing Wisely Switzerland:
When deciding on life-sustaining measures, it is important to consider the patient’s wishes.
Recommendation from Choosing Wisely Canada:
Don’t delay advance care planning conversations.
Recommendation from Choosing Wisely Canada:
Don’t offer therapies on the basis of survival benefit without establishing your patient’s prognosis, preferences, and goals of care.
Recommendation from Choosing Wisely Australia:
For patients with limited life expectancy (such as advanced cardiac, renal or respiratory failure, metastatic malignancy, third line chemotherapy) ensure patients have a ‘goals of care’ discussion at or prior to admission to ICU and for patients in ICU who are at high risk for death or severely impaired functional recovery, ensure that alternative care focused predominantly on comfort and dignity is offered to patients and their families.
Referenzen
- https://www.smartermedicine.ch/de/datensammlung/detail/empfehlung/patient/lebenserhaltende-massnahmen-sorgfaeltig-abklaeren
- https://choosingwiselycanada.org/recommendation/palliative-care/
- https://choosingwiselycanada.org/recommendation/cardiology/
- https://www.choosingwisely.org.au/recommendations/anzics1
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Do you have any questions?
You can find information about smarter medicine - Choosing Wisely Switzerland on the following website. Feel free to send us feedback regarding «informed by smarter medicine» by e-mail.