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.

Sponsoring Organizations

American Society of Health-System Pharmacists

Sources

Expert consensus

Disciplines

Geriatric Medicine
Preventive Medicine

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.