PMID- 31107036
OWN - NLM
STAT- MEDLINE
DCOM- 20191223
LR  - 20191223
IS  - 1122-0643 (Print)
IS  - 1122-0643 (Linking)
VI  - 89
IP  - 2
DP  - 2019 May 20
TI  - Choosing wisely in cardiology: Five proposals from the Italian Association for 
      Cardiovascular Prevention and Rehabilitation.
LID - 10.4081/monaldi.2019.1049 [doi]
AB  - We do not always accomplish what is best for our patients. Is "more procedures, 
      more drugs" a real synonym of good and always useful medicine? Probably not. 
      Indeed, it has been highlighted that many tests and treatments, widely used in 
      medical practice, do not bring benefits to patients, but they can be harmful. So, 
      why do we keep performing them? Many reasons, surely one of the main is the 
      constant fear of malpractice legal-medical consequences; this led to the 
      development of a defensive medicine, no longer focused on the health of the 
      patient. For this reason, the Italian Association of Cardiac Prevention and 
      Rehabilitation (GICR-IACPR) joined an international project "Choosing Wisely", 
      supported by the Slow Medicine Initiative, a network which states that "Less is 
      more". The purpose of "Choosing Wisely " project is to improve the quality and 
      safety of health services through the reduction of practices that, according to 
      available scientific knowledge, do not bring significant benefits to the 
      patients, but can, on the contrary, expose them to risks. This GICR-IACPR paper 
      proposes to avoid five widespread practices in cardiology, at risk for 
      inappropriateness and lacking of clinical evidence of benefit: * Do not perform 
      routine chest X-ray in patients entering rehabilitation programme after cardiac 
      surgery * Do not perform Computed Tomography for coronary calcium score in 
      patients at high cardiovascular risk * Do not perform Holter electrocardiographic 
      monitoring in patients suffering from syncope, near syncope or dizziness, in whom 
      a non-arrhythmic origin has been documented * Do not routinely prescribe proton 
      pump inhibitors (PPI) for gastrointestinal bleeding prophylaxis in patient with 
      single drug antiplatelet therapy in absence of additional risk factors. * Avoid 
      routine use of infective endocarditis prophylaxis in mild to moderate native 
      valve disease.
FAU - Werren, Marika
AU  - Werren M
AD  - Istituto di medicina fisica e riabilitazione "Gervasutta", Cardiac Rehabilitation 
      Unit. marika.werren@asuiud.sanita.fvg.it.
FAU - Copetti, Roberto
AU  - Copetti R
FAU - Gaibazzi, Nicola
AU  - Gaibazzi N
FAU - Giada, Franco
AU  - Giada F
FAU - Faggiano, Andrea
AU  - Faggiano A
FAU - Ricci, Chiara
AU  - Ricci C
FAU - Faggiano, Pompilio
AU  - Faggiano P
LA  - eng
PT  - Journal Article
DEP - 20190520
PL  - Italy
TA  - Monaldi Arch Chest Dis
JT  - Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace
JID - 9307314
RN  - 0 (Anti-Infective Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Infective Agents/therapeutic use
MH  - Cardiac Rehabilitation
MH  - Cardiology/*methods/*standards
MH  - Coronary Vessels/diagnostic imaging
MH  - Electrocardiography, Ambulatory
MH  - Endocarditis/etiology/*prevention & control
MH  - Gastrointestinal Hemorrhage/chemically induced/*prevention & control
MH  - Heart Valve Diseases/complications
MH  - Humans
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - Proton Pump Inhibitors/therapeutic use
MH  - *Quality Improvement
MH  - Radiography, Thoracic
MH  - Risk Factors
MH  - Syncope/etiology
MH  - Tomography, X-Ray Computed
MH  - *Unnecessary Procedures
MH  - Vascular Calcification/diagnostic imaging
EDAT- 2019/05/21 06:00
MHDA- 2019/12/24 06:00
CRDT- 2019/05/21 06:00
PHST- 2019/02/15 00:00 [received]
PHST- 2019/04/08 00:00 [accepted]
PHST- 2019/05/21 06:00 [entrez]
PHST- 2019/05/21 06:00 [pubmed]
PHST- 2019/12/24 06:00 [medline]
AID - 10.4081/monaldi.2019.1049 [doi]
PST - epublish
SO  - Monaldi Arch Chest Dis. 2019 May 20;89(2). doi: 10.4081/monaldi.2019.1049.