Don’t initiate medications to treat symptoms, adverse events, or side effects without determining if an existing therapy or lack of adherence is the cause, and whether a dosage reduction, discontinuation of a medication, or another medication is warranted.
|Rationale and Comments:||New medications should not be initiated without taking into consideration patient compliance with their preexisting medication and whether their current dose is effective at controlling/treating symptoms. Medications are often prescribed to treat symptoms that are really side effects of other medications without determining if the preexisting medication is truly needed or could be discontinued.|
|References:||• Schiff GD, et al. Promoting more conservative prescribing. JAMA 2009;301:865-7.
• Schiff GD, et al. Principles of conservative prescribing. Arch Intern Med. 2011;171:1433-40.
• Shane, R and Abramowitz, PW. Choosing Wisely: Pharmacy’s role in effective use of medications. Am J Health-Syst Pharm. 2015; 72:1529-30. doi.org/10.2146/ajhp150324.