Tools to Reduce Low-Value Care: Lessons From COVID-19 Pandemic; Comment on “Key Factors that Promote Low-Value Care: Views of Experts From the United States, Canada, and the Netherlands”

Document Type : Commentary


1 Medicine, Dermatology and Toxicology Department, Universidad de Valladolid, Valladolid, Spain

2 Internal Medicine Department, Hospital Universitario Río Hortega, Valladolid, Spain


Based on a summary of interviews with 18 experts, Verkerk et al defined the seven key factors that promoted lowvalue care, which included system, social, and knowledge factors. During the ongoing coronavirus disease 2019 (COVID-19) pandemic, these key factors have been influential due to the uncertainty of the disease at the beginning of the pandemic. Globally, several measures have been implemented to reduce low-value care practices and promote high-value care for COVID-19 patients. From huge multicenter, non-industry sponsored or multiplatform trials, to the use of social networks sites is an indispensable and effective way to disseminate medical information. Thanks to these measures, we have transformed a scenario of ignorance into an evidence-based medical scenario in less than a year. Verkerk and colleagues’ proposed key factors are an excellent framework for characterizing and highlighting the lessons that can be learnt from how we have fought against the pandemic and low-value practices.


Main Subjects

  1. Verkerk EW, Van Dulmen SA, Born K, Gupta R, Westert GP, Kool RB. Key factors that promote low-value care: views of experts from the United States, Canada, and the Netherlands. Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.53
  2. Saini V, Garcia-Armesto S, Klemperer D, et al. Drivers of poor medical care. Lancet. 2017;390(10090):178-190. doi:1016/s0140-6736(16)30947-3
  3. Corral-Gudino L. Treatment of the COVID-19 pandemic: preventing a missed opportunity. Rev Clin Esp (Barc). 2020;220(6):386-387. doi:1016/j.rce.2020.04.005
  4. Watanabe JH, Kwon J, Nan B, Abeles SR, Jia S, Mehta SR. Medication use patterns in hospitalized patients with COVID-19 in California during the pandemic. JAMA Netw Open. 2021;4(5):e2110775. doi:1001/jamanetworkopen.2021.10775
  5. Balaz D, Wikman-Jorgensen PE, Galvañ VG, et al. Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID National Registry. J Clin Med. 2021;10(19):4610. doi:3390/jcm10194610
  6. Calderón-Parra J, Muiño-Miguez A, Bendala-Estrada AD, et al. Inappropriate antibiotic use in the COVID-19 era: factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID. PLoS One. 2021;16(5):e0251340. doi:1371/journal.pone.0251340
  7. Pessoa-Amorim G, Campbell M, Fletcher L, et al. Making trials part of good clinical care: lessons from the RECOVERY trial. Future Healthc J. 2021;8(2):e243-e250. doi:7861/fhj.2021-0083
  8. Pan H, Peto R, Henao-Restrepo AM, et al. Repurposed antiviral drugs for COVID-19 - interim WHO solidarity trial results. N Engl J Med. 2021; 384(6):497-511. doi:1056/NEJMoa2023184
  9. Riccioni L, Ingravallo F, Grasselli G, et al. The Italian document: decisions for intensive care when there is an imbalance between care needs and resources during the COVID-19 pandemic. Ann Intensive Care. 2021; 11(1):100. doi:1186/s13613-021-00888-4
  10. Pramesh CS, Babu GR, Basu J, et al. Choosing Wisely for COVID-19: ten evidence-based recommendations for patients and physicians. Nat Med. 2021;27(8):1324-1327. doi:1038/s41591-021-01439-x
  11. Cliff BQ, Avanceña ALV, Hirth RA, Lee SD. The impact of Choosing Wisely interventions on low-value medical services: a systematic review. Milbank Q. 2021;99(4):1024-1058. doi:1111/1468-0009.12531
  12. Lawler PR, Goligher EC, Berger JS, et al. Therapeutic anticoagulation with heparin in noncritically ill patients with COVID-19. N Engl J Med. 2021;385(9):790-802. doi:1056/NEJMoa2105911
  13. Jung RG, Di Santo P, Clifford C, et al. Methodological quality of COVID-19 clinical research. Nat Commun. 2021;12(1):943. doi:1038/s41467-021-21220-5
  14. Tangcharoensathien V, Calleja N, Nguyen T, et al. Framework for managing the COVID-19 infodemic: methods and results of an online, crowdsourced WHO technical consultation. J Med Internet Res. 2020;22(6):e19659. doi:2196/19659
  15. Hofmann B. Internal barriers to efficiency: why disinvestments are so difficult. Identifying and addressing internal barriers to disinvestment of health technologies. Health Econ Policy Law. 2021;16(4):473-488. doi:1017/s1744133121000037
Volume 11, Issue 9
September 2022
Pages 1967-1970
  • Receive Date: 25 October 2021
  • Revise Date: 21 March 2022
  • Accept Date: 28 March 2022
  • First Publish Date: 29 March 2022