Choosing Wisely—Barriers and Solutions to Implementation in Low and Middle-Income Countries |
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Authors: | Fidel Rubagumya Manju Sengar Sidy Ka Nazik Hammad Christopher M. Booth Safiya Karim |
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Affiliation: | 1.Department of Clinical Oncology, Rwanda Military Hospital, Kigali 3377, Rwanda;2.Division of Cancer Care and Epidemiology, Queen’s University Cancer Research Institute, Kingston, ON K7L 3N6, Canada;3.Departments of Oncology, Queen’s University, Kingston, ON K7L 3N6, Canada;4.Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400094, India;5.Cheikh Anta Diop University, Dakar 5005, Senegal;6.Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 1N4, Canada; |
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Abstract: | Globally, there is increasing emphasis on value-based cancer care. Rising healthcare costs and reduced health care spending and budgets, especially in low- and middle-income countries (LMICs), call for patients, providers, and healthcare systems to apply the Choose Wisely (CW) approach. This approach seeks to advance a dialogue on avoiding unnecessary medical tests, treatments, and procedures. Several factors have been described as barriers and facilitators to the implementation of the Choosing Wisely recommendations in high-income countries but none for LMICs. In this review, we attempt to classify potential barriers to the Choose Wisely implementation relative to the sources of behavior and potential intervention functions that can be implemented in order to reduce these barriers. |
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Keywords: | Choosing Wisely Africa value-based cancer care low and middle-income countries |
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