American Society of Health-System Pharmacists

View all recommendations from this society

June 1, 2017

Do not 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.

New medications should not be initiated without taking into consideration patient compliance with their pre-existing 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 pre-existing medication is truly needed or could be discontinued.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

A task force made up of pharmacists from all practice settings was formed. The task force was oriented to the criteria used to establish Choosing Wisely lists and already established recommendations. Based on this information and on their knowledge of how medications are prescribed, dispensed, and administered, the task force developed an initial list of recommendations. Over time this list was vetted, evaluated, researched, and referenced. Through a consensus process over time the list was prioritized down to a total of five recommendations. This list was approved by the ASHP Board of Directors.

Sources

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.