Introducing CSHP’s Choosing Wisely Canada Recommendations

By: Amanda Iannaccio


The Choosing Wisely Canada national campaign aims to help clinicians and patients engage in conversations about unnecessary tests and treatments, and make smart and effective care choices.

CSHP is happy to present the member-generated recommendations for consideration when striving for excellence in providing patient care.

Six things that clinicians and patients should know about hospital pharmacy. CWC Canada

CSHP’s Choosing Wisely Canada Recommendations

Don’t continue medications that are no longer indicated or where the risks outweigh the benefits.
Don’t use a medication for long-term risk reduction if life expectancy is shorter than the time to benefit of the medication.
Don’t continue a proton pump inhibitor at discharge unless there is a compelling reason to continue therapy.
Don’t start or prolong broad-spectrum antibiotic treatment unless clinically indicated.
Don’t routinely prescribe benzodiazepines or other sedative-hypnotics for promotion of sleep without first a trial of non-pharmacologic interventions.
Don’t initiate or escalate opioid doses for chronic non-cancer pain before optimizing nonopioid pharmacotherapy and non-pharmacologic therapy.

To see the complete list with background information, visit the CSHP website.

How the CSHP recommendations were created: CSHP formed a working group of pharmacists who practice in a variety of settings. Members of CSHP were invited to contribute recommendations to CSHP, via email, an online survey, and paper forms. The suggested recommendations were reviewed by the working group. Two lists of candidate recommendations resulted: “medication-based” and “practice-based”. CSHP members were asked to identify their “top 5 recommendations” in each of those two categories. The results were reviewed and those proposed recommendations that had support from at least 40% of the respondents were included on a shortened list.

Evidence supporting each of CSHP’s proposed recommendations was gathered. Further, Choosing Wisely Canada’s recommendations from other organizations were reviewed to identify if similar recommendations already exist. The proposed recommendations were compared to identify and address duplication. CSHP’s Board voted on the draft set of recommendations in October 2018. After the recommendations were approved by Choosing Wisely Canada, CSHP’s Board approved the final set of recommendations in January 2019.

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