Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 11 8 2022 08 01 Context, Culture, and the Complexity of De-Implementing Low-Value Care; Comment on “Key Factors that Promote Low-Value Care: Views of Experts From the United States, Canada, and the Netherlands” 1592 1594 4201 10.34172/ijhpm.2022.6968 EN Emma E. Sypes Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Jeanna Parsons Leigh School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada Henry T. Stelfox Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada Daniel J. Niven Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada Journal Article 2021 11 27 <span class="fontstyle0">Low-value care contributes to poor quality of care and wasteful spending in healthcare systems. In Verkerk and colleagues’ recent qualitative study, interviews with low-value care experts from Canada, the United States, and the Netherlands identified a broad range of nationally relevant social, system, and knowledge factors that promote ongoing use of low-value care. These factors highlight the complexity of the problem that is persistent use of low-value care and how it is heavily influenced by public and medical culture as well as healthcare system features. This commentary discusses how these findings integrate within current low-value care and de-implementation literature and uses specific low-value care examples to highlight the importance of considering context, culture, and clinical setting when considering how to apply these factors to future de-implementation initiatives.</span> https://www.ijhpm.com/article_4201_8be24d42e2c32c40fdb8fd9ef514aaa7.pdf