Top POEMs (Patient-Oriented Evidence that Matters) of 2022 for choosing wisely in practice

Summary: Top POEMs of 2022 for choosing wisely in practice are based on Canadian Medical Association member ratings. These recommendations promote evidence-based and cost-effective clinical practices while reducing unnecessary treatments and diagnostic procedures.

Key recommendations from the article:

1. Hypnotic agents are effective for insomnia but have adverse effects; avoid benzodiazepines as the first choice for older adults.
2. For type 2 diabetes in older adults, avoid medications causing hypoglycemia to achieve A1c <7.5%; moderate control is better.
3. Postoperative opioids provide no better pain relief than nonopioids; avoid prolonged use beyond the immediate postoperative period.
4. Arthroscopic debridement is not recommended as the primary treatment for knee osteoarthritis.
5. Proton pump inhibitor (PPI) use is associated with an increased risk of gastric cancer, although the association is observational and does not imply causation. Use the lowest dose and duration possible.
6. For children with community-acquired pneumonia, low-dose amoxicillin for 3 days is noninferior to high-dose for 7 days.
7. White blood cells in urine do not equate to bacterial cells; avoid urine dip tests or cultures unless urinary tract symptoms are present.
8. Avoid measuring vitamin D in low-risk adults as a routine test.
9. Antidepressants should not be routinely used as first-line treatment for mild or subsyndromal depressive symptoms in adults.
10. ACG guideline for GERD management: try discontinuing PPIs after an 8-week trial in patients with classic GERD symptoms & no alarming symptoms.
11. British Society of Gastroenterology guidelines for IBS management: colonoscopy only for alarming signs or microscopic colitis risk.
12. USPSTF advises against ASA initiation for primary prevention of cardiovascular disease in adults >60.

Top POEMs of 2022 for choosing wisely in practice – Canadian Family Physician

See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada