New Choosing Wisely pharmacy recommendations

More than 40 New Zealand pharmacists have worked together to develop new Choosing Wisely pharmacy recommendations.

Choosing Wisely is a global initiative promoting a culture where low value and inappropriate clinical interventions are avoided, and patients and health professionals have well-informed conversations about their treatment options, leading to better decisions and outcomes.

Initially the group of New Zealand pharmacists reviewed recommendations from other pharmacy groups world-wide. They then narrowed them down to the ones they believe work in a New Zealand context and would have the most impact.

The new recommendations for pharmacists include:

• Not recommending complementary medicines or therapies without reviewing the patient’s medicine regime to assess for safety and ensure the benefit of use outweighs the risk.
• Question repeated prescription of over the counter (OTC) supply of a NSAID, colchicine and or prednisone for the acute treatment of gout. Ensure patients who suffer from gout are managed appropriately with a urate lowering agent (eg, allopurinol or febuxostat).
• Identify and ensure at-risk patients are not exposed to ‘the triple whammy’ – a diuretic plus ACE-I or ARB and a NSAID or COXIB.
• Do not dispense regular opioids without checking the requirement for laxatives.

More information about the rationale for these recommendations, including how they were developed, is available on the Choosing Wisely website.