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  • 'Choosing Wisely' App Now Available

    Now it's easier than ever for consumers to make well-informed health care choices—including choices about physical therapist interventions.

    The American Board of Internal Medicine Foundation has unveiled the first "Choosing Wisely" app for iPhone (iPad and Android versions to follow soon), a tool that enables consumers and clinicians to access more than 500 specialty society recommendations on procedures that tend to be done frequently, yet whose usefulness is called into question by evidence. The program was developed in partnership with Consumer Reports.

    Through the new app, clinicians and consumers will be able to search the recommendations using keywords and filter by specialty, age, setting, and service (for example, imaging, medication, treatment, lab, or test). Recommendations are linked to relevant patient-friendly resources, and information can be shared via text or email.

    APTA was the first nonphysician group to release a "Choosing Wisely" list in the fall of 2014, joining more than 50 medical specialty societies participating at the time. The 5 APTA recommendations, which are expanded upon with citations at the Choosing Wisely website and in the downloadable list of "5 Things Physical Therapists and Patients Should Question," are:

    • Don't use (superficial or deep) heat to obtain clinically important long-term outcomes in musculoskeletal conditions.
    • Don’t prescribe under-dosed strength training programs for older adults. Instead, match the frequency, intensity, and duration of exercise to the individual’s abilities and goals.
    • Don’t recommend bed rest following diagnosis of acute deep vein thrombosis (DVT) after the initiation of anti-coagulation therapy unless significant medical concerns are present.
    • Don’t use continuous passive motion machines for the postoperative management of patients following uncomplicated total knee replacement.
    • Don’t use whirlpool for wound management.

    The process for developing the list began with an open call for APTA members to submit their lists of questionable procedures. After receiving more than 170 submissions, APTA convened an expert group of physical therapists from a wide range of practice settings and areas of clinical expertise. The group reviewed all nominations and conducted extensive literature reviews to narrow down the list to 9 procedures. The list of 9 was presented to the members of APTA, who voted on the final 5.

    APTA's participation in "Choosing Wisely" is part of the association's Integrity in Practice campaign to support the profession of physical therapy as a leader in the elimination of fraud, abuse, and waste in health care. The APTA Center for Integrity in Practice houses information on the "Choosing Wisely" program as well as a primer on preventing fraud, abuse, and waste, an online course on compliance and professional integrity, and other resources.

    Comments

    • After 50 or more years of research, that was the best you put in? What about sham modalities like ultrasound, tens, not using ice, kinesiotape, looking for skilled interventions from a PT and not an aide, to stay away from three sets of ten boiler plate exercise and that if you aren't better for simple injuries in 2 weeks, you aren't getting benefit from the therapy?

      Posted by Adam Iannazzo on 8/2/2017 3:48 PM

    • Great resource. So happy that APTA was early at the table with this initiative. So helpful to have it as an app.

      Posted by Judith Deutsch on 8/2/2017 3:56 PM

    • I agree with Adam - if that is the outcome of the "evidence based practice" we should all fold right now.

      Posted by Marek Grzybowski -> AOX^>H on 8/7/2017 2:25 PM

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