Activities of Choosing Wisely and Role of Pharmacists

Choosing Wisely (CW) is a pharmaceutical campaign activity that is spreading rapidly internationally. Briefly, it is an activity "aiming for appropriate medical care by reviewing the medical practice that is practiced despite lack of evidence from the viewpoint of evidence based medicine (EBM)". Here, healthcare workers and patients, through dialogue, are aiming to be able to carry out medical practices (examinations, treatment) that are scientifically validated, truly necessary, and have few side effects. In 2012, the American Institute of Internal Medicine listed five topics (Top Five Lists) and presented the medical practices and reasons that should be reconsidered. Based on this, many academic societies and medical professional organizations around the world presented five unique lists from their respective standpoints. And, in 2016, CW Japan was established in our country. The ultimate goal of this activity is to encourage dialogue and share decision-making with the patients so that healthcare workers can "select wisely" appropriate medicine for their patients based on professionalism. In Japan, recent attention has also been paid to problems concerning proper use of polypharmacy and antibiotics, especially for elderly people. To support a sustainable medical system in the future, it is desirable to promote efforts to realize "high-value care" for patients, paying particular attention to limit unnecessary medical care. Under such circumstances, I will introduce some issues and activities that overseas pharmacists are working on in the context of CW, and discuss roles and tasks to be taken by pharmacists in Japan.