AAAAI Issues New Round of 'Don'ts Designed to Improve Patient Care


The American Academy of Allergy, Asthma & Immunology (AAAAI) on Monday released its second list of overused tests and procedures that allergists, primary care physicians, and patients should question before they occur. The list represents the fruits of the Academy’s second year of participation in the “Choosing Wisely” initiative, and was presented at a press conference during the Academy’s meeting in San Diego, California.

“Choosing Wisely,” a project of the ABIM Foundation, asks leading professional associations across medicine to scrutinize those actions within each specialty that may be overused at the expense of quality care. “The intent is that the evidence shows that much of the care that is delivered in America is unnecessary,” said Linda Cox, MD, who was completing her term as AAAAI president. “It’s really about starting a conversation between the patients and their physicians.”

While issuing the list and curtailing the excess may save healthcare dollars, Dr Cox and the other AAAAI leaders who spoke at Monday’s press conference emphasized that the priority of “Choosing Wisely” is providing better care and outcomes for patients.
 
“We didn’t look at money. That’s not what ‘Choosing Wisely’ is about,” said Theodore M. Freeman, MD, who chaired the “Choosing Wisely” committee for AAAAI. The other presenters, David M. Lang, MD, and John Oppenheimer, MD, agreed with Dr Freeman that quality of care is what is at issue, as some downstream effects of improper tests are hard to measure—such as not eating a favorite food because of a misdiagnosed “allergy.”
 
AAAAI’s “Choosing Wisely” list for 2014 includes:
 
 
 
 
 
 
With plenty of discussion at this year’s AAAAI meeting surrounding the use of electronic health records (EHRs), including to improve adherence to asthma medications, the 4 physicians agreed that EHRs would possibly help implement many of the 2014 recommendations, as well as those put in place a year ago. The doctors offered examples, such as a record asking whether a patient’s reported pencillin allergy has been clinically confirmed, or whether a patient who is told he has an asthma diagnosis has had spirometry—a common pulmonary test to measure lung function—which was included in the 2013 “Choosing Wisely” campaign from AAAAI.
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