Choosing Wisely must not increase inequity

The Choosing Wisely campaign is supporting Wiki Haumaru Tūroro | Patient Safety Week, which has a focus on reducing inequity and understanding bias in health care. Patient Safety Week is coordinated by the Health Quality & Safety Commission, which is a Choosing Wisely partner.

Clinical lead Dr Derek Sherwood says the Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment, but this must not be at the expense of equity.

“Unless equity is explicitly considered, new health care interventions or campaigns have the tendency to widen inequities,” he says. “This is because they are taken up first by those in society with the most resources and the least need.

“For example, a recommendation not to prescribe antibiotics for upper respiratory tract infections may sound reasonable given the majority of these infections are viral and antimicrobial resistance is a rising concern. However, for Māori and Pacific children in New Zealand, who experience high rates of rheumatic fever, sore throats should be swabbed and treated with antibiotics until swab results are available.”

Dr Sherwood says Choosing Wisely has been working to ensure the campaign does not increase inequities in health for Māori.

“We are partnering with Te ORA, conducting research to improve shared decision-making between health professionals and Māori consumers and their whānau, increasing our advocacy in this area, and reviewing governance statements on the Choosing Wisely website in relation to equity.”

He says Choosing Wisely asks colleges and specialty societies developing new recommendations to consider those areas with the greatest impact in reducing health inequities in New Zealand when selecting topics for recommendations for their area. ·

“It is also important that current recommendations are reviewed using an equity lens to ensure they are appropriate for all groups. Organisations have a responsibility to evaluate the potential impact on health inequities of their recommendations and be very clear when communicating where these need to be modified for sub-populations.”

About Patient Safety Week

This year Wiki Haumaru Tūroro | Patient Safety Week has a focus is on reducing inequity, and includes the development of three videos on understanding bias in health care. The videos are available on the Health Quality & Safety Commission’s website.