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According to the nephrology recommendation in the Choosing Wisely campaign, non-steroidal anti-inflammatory drugs should be avoided in people with cardiac and renal diseases. This study provides quantitative data on the use of NSAIDs in Switzerland as well as indications of how the billing frequency of NSAIDs in high-risk individuals has changed since the introduction of the recommendation. Method: Secondary analysis of billing data from compulsory health insurance. The frequency of NSAID use was stratified by sociodemographics and the comorbidities "cardiology" and "renal insufficiency". Results: It was shown for the first time that 33.6% of the total study population, 42.1% of the cardiac risk population and 18% of the renal risk population used NSAIDs. There was a slight tendency for the billing frequency to decrease after the introduction of the recommendation. Discussion: Further studies are needed as a matter of priority to quantify the use of potentially harmful NSAIDs in other risk groups and, on the basis of the ensuing study results, a wider use of the Choosing Wisely recommendations must be considered, especially in the general population. [ABSTRACT FROM AUTHOR]

Background: Preoperative chest radiography in the absence of a clinical suspicion for intrathoracic pathology is part of the Top-5 list of the Swiss «Smarter Medicine»-initiative. This study investigates the proportion of futile preoperative chest radiographies in Switzerland. Methods: Secondary analysis of claims data from hospitalized persons with basic obligatory health insurance. Proportion of preoperative chest radiography was stratified for socioeconomics and cardiovascular disease and respiratory illness. Results: Of 47 215 hospitalized persons, 6121 (13%) had an ambulatory preoperative chest radiography. There was considerable intercantonal variation. Discussion: There is no indication for excessive use of futile preoperative chest radiography in Switzerland. Intercantonal differences may indicate unwarranted variation. This study contributes arguments for including health services research data in future Top-5 lists. [ABSTRACT FROM AUTHOR]