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Do not use oral beta2 agonists as bronchodilators in asthma, wheeze or bronchiolitis.
Choosing Wisely Australia
The Thoracic Society of Australia and New Zealand
The weight of evidence does not support the use of oral beta2 agonists as bronchodilators in children with asthma, wheeze or bronchiolitis. In the case of asthma, oral beta2 agonists have not been shown to have a significant impact on symptom score or length of hospital stay for acute asthma in infancy when compared to placebo. For wheeze inhalation is the recommended route for delivering relievers for all children and adults. For bronchiolitis, according to the latest evidence, oral ...
ver más ... 2018Do not prescribe antibiotics for exacerbation of asthma.
Choosing Wisely Australia
The Thoracic Society of Australia and New Zealand
The most recent Global Initiative for Asthma (GINA) report does not recommend a role for antibiotics in management of asthma exacerbation unless there is strong evidence of lung infection, such as fever and purulent sputum or radiographic evidence of pneumonia. This is supported by recent trials involving azithromycin (a commonly prescribed antibiotic for management of asthma), which found that this drug had no statistically significant impacts on severity of symptoms during an exacerbation. ...
ver más ... 2018Do not recommend complementary medicines or therapies unless there is credible evidence of efficacy and the benefit of use outweighs the risk.
Choosing Wisely Australia
Pharmaceutical Society of Australia
Complementary medicines may also be called 'traditional' or 'alternative' medicines and include items such as vitamins, minerals, herbal products, aromatherapy and homoeopathic products. Many of the products available in pharmacies, supermarkets or health food outlets have limited evidence of efficacy. There is some evidence of efficacy for some complementary medicines, however this may be formulation and dose dependent, and health practitioners are encouraged to seek this information before ...
ver más ... 2018Do not prescribe combination therapy (inhaled corticosteroids with long-acting beta2 agonist) as initial therapy in mild to moderate asthma before a trial of inhaled corticosteroids alone.
Choosing Wisely Australia
The Thoracic Society of Australia and New Zealand
Even for children with persistent asthma, the most recent evidence suggests that adding long-acting beta2 agonists to inhaled corticosteroids does not result in a statistically significant reduction in exacerbations. However, there is some evidence that LABA/ICS combination therapy increases the risk of hospital admissions and severe asthma-associated adverse events, particularly among asthmatic children aged 4 to 11 years old. Due to the limited paediatric evidence on the safety and efficacy ...
ver más ... 2018Do not use Mini Mental State Examination as the only tool to assess cognitive deficit in acquired brain injury
Choosing Wisely Australia
Australasian Faculty of Rehabilitation Medicine
Numerous studies suggest that the Montreal Cognitive Assessment (MoCA) is one of the most effective means of assessing cognitive deficits in acquired brain injury (for instance after transient ischemic attack and stroke) and is to be preferred to the Mini Mental State Evaluation (MMSE). MMSE may under-detect cognitive impairment in acquired brain injury; it is more appropriate for assessing dementia.
ver más ... 2018